Individual provider Active NPI

Ryan Stephen Roessler, DPT

  • Physical Therapist
  • Fort Worth, TX
National Provider Identifier
1083239305
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1334849 Issued in TX
Practice address
1001 12TH Ave Ste 201
Fort Worth, TX 76104-3946
Phone
(817) 719-7714
NPI assigned
Jun 12, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1334849 TX Primary

Addresses

Primary practice location

1001 12TH Ave Ste 201
Fort Worth, TX 76104-3946

Mailing address

1001 12TH Ave Ste 201
Fort Worth, TX 76104-3946
Phone (817) 719-7714

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200709001669 TX Practitioner - Physical Therapist in Private Practice 5294158291 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clearcut Ortho LLCGroup PAC ID 2365794609, 14 clinicians

Practice addresses (Care Compare)

1001 12TH Ave
Suite 201
Fort Worth, TX 76104-3946
Phone (817) 719-7714

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Clearcut Ortho, LLC Physical Therapist CurrentSince Dec 30, 2021 Accepting new patients
Fort Worth Head Neck and Jaw PLLC CurrentSince Jan 11, 2021 Accepting new patients
Peter D Leonard, M.D. PA PastSince Dec 30, 2021 Accepting new patients

Locations

6145 Wedgwood Dr
Fort Worth, TX 76133
Phone (817) 370-8022

1001 12th Ave
Ste 201
Ft Worth, TX 76104
Phone (817) 719-7714

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FIDCCD/Endpoint/FIDCCD

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1591920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1083239305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 12TH AVE STE 201",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043946",
            "telephone_number": "817-719-7714",
            "fax_number": "817-841-1295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 12TH AVE STE 201",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043946",
            "telephone_number": "817-719-7714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROESSLER",
        "first_name": "RYAN",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-12",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1334849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.