Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Venessa Marie Mazur, MSPAS, PA-C

Individual provider Physician Assistant · NPI 1083928014

Venessa Marie Mazur, MSPAS, PA-C is a Physician Assistant in Fort Worth, Texas. Qualified in 2010, 16 years ago. Practices with Poudre Valley Medical Group LLC, a 2,416-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Colorado and Texas.

Years since qualifying
16
Licensed in
CO, TX
In the registry since
2010
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1250 8th Ave Ste 650
Fort Worth, TX 76104-4160
Phone: (817) 912-9180
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA.0003966 (CO)
Physician Assistant Taxonomy 363A00000X · Licence PA06838 (TX)

Record details

NPI number1083928014
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSPAS , PA-C
Sole proprietorNo
NPI enumeratedAugust 2, 2010
Last updated in NPPESJune 2, 2026
Certification dateJune 2, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Poudre Valley Medical Group Llc — 2416 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

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