Individual provider Active NPI

Douglas Trippe, M.D.

  • Diagnostic Radiology Physician
  • Texarkana, TX
National Provider Identifier
1093716631
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
H4753 Issued in TX
Practice address
5508 Summerhill Rd
Texarkana, TX 75503-1822
Phone
(903) 792-1292
Fax
(903) 792-2051
NPI assigned
Aug 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X H4753 TX Primary

Addresses

Primary practice location

5508 Summerhill Rd
Texarkana, TX 75503-1822

Mailing address

816 W Cannon St
Fort Worth, TX 76104-3194
Phone (817) 321-0404

Other identifiers 2

IdentifierTypeStateIssuer
136937304MedicaidTX
300039219OtherTXRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041102000987 TX Practitioner - Diagnostic Radiology 5890757090 Reassigns benefits to 1 organization
I20110718000656 AR Practitioner - Diagnostic Radiology 5890757090 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Texas Medical School at San Antonio, 1987
Medicare assignment
May accept Medicare assignment
Group practices
Radiology Associates of North Texas PAGroup PAC ID 7911897301, 340 clinicians

Practice addresses (Care Compare)

2001 S Main St
Hope, AR 71801-8144
Phone (817) 321-0404

805 Trinity Dr
Hope, AR 71801-3621
Phone (817) 321-0404

815 Pennsylvania Ave
Fort Worth, TX 76104-2224
Phone (817) 321-0470

Hospital & facility affiliations

  • Christus St Michael Health System Hospital, Texarkana, TX, CCN 450801
  • Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102
  • Southwest Regional Medical Center LLC Hospital, Hope, AR, CCN 041335
  • Sevier County Medical Center Hospital, De Queen, AR, CCN 041333

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates of North Texas, PA Diagnostic Radiology CurrentSince Dec 1, 2021 Accepting new patients
Radiology Associates of North Texas PA Diagnostic Radiology CurrentSince Dec 1, 2021 Accepting new patients
Clinical Care in Radiology Past Accepting new patients

Locations

2001 S Main St
Hope, AR 71801
Phone (870) 722-3800

17980 Dallas Pkwy
Ste 200
Dallas, TX 75287
Phone (972) 248-1303

815 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 321-0300

816 W Cannon St
Ft Worth, TX 76104
Phone (817) 321-0312

1000 Pine St
Texarkana, TX 75501
Phone (903) 798-7365

5508 Summerhill Rd
Texarkana, TX 75503
Phone (430) 455-2715

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1123113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1093716631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 W CANNON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043194",
            "telephone_number": "817-321-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5508 SUMMERHILL RD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755031822",
            "telephone_number": "903-792-1292",
            "fax_number": "903-792-2051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIPPE",
        "first_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-04",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "H4753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136937304",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300039219",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

Verify at the official NPI Registry.