Samuel Crist, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD2022-1080 Issued in NM

Practice address

1500 S Main St
Ft Worth, TX 76104-4917

Phone

(817) 702-8840

NPI assigned

Mar 27, 2019

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

88.68 of 100Reported as group

Quality

82.35

Promoting interoperability

100

Improvement activities

40

Cost

76.6

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fedko Emergency Physicians New Mexico LLC

  • Emergency Medicine Physician
  • Grants, NM
  • NPI 1770047441
  Medicare reassignment NPD
• Presbyterian Healthcare Services

  dba Presbyterian Medical Group

  • Internal Medicine Physician
  • Albuquerque, NM
  • NPI 1104802354
  Medicare reassignment NPD
• Presbyterian Healthcare Services

  dba Presbyterian Hospital

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1215913470

  Emergency Medicine

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1053872572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761044917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761044917",
            "telephone_number": "817-702-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIST",
        "first_name": "SAMUEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-27",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NM",
            "license": "MD2022-1080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ella McKay Crimmings, LMSW
• Catherine Crimmins
• Linzi Crisafulli, PT, DPT
• Kelli Crisp, DPT
• Michelle Criss, AGACNP-BC
• Taylor Evan Crist
• Cristela Flores Serenity Hospice LLC (Serenity Hospice)
• Ricardo Cristobal, M.D.
• Jared Criswell, M.D.
• Gay Elaine Crites, LMSW

• Emergency Medicine Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.