NPIMap

Individual provider Active NPI

Douglas Darko Dickson, MD

  • Orthopaedic Surgery Physician
  • Fort Worth, TX
National Provider Identifier
1093918245
Registry record updated Jul 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
P1746 Issued in TX
Practice address
855 Montgomery St
Fort Worth, TX 76107-2553
Phone
(817) 735-2900
NPI assigned
Jun 6, 2007
Last updated
Jul 8, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 57.010466 OH
Orthopaedic Surgery Physician 207X00000X P1746 TX Primary
Orthopaedic Surgery of the Spine Physician 207XS0117X P1746 TX

Addresses

Primary practice location

855 Montgomery St
Fort Worth, TX 76107-2553

Mailing address

PO Box 99335
Fort Worth, TX 76199-0335
Phone (817) 735-2900

Other identifiers 3

IdentifierTypeStateIssuer
296488401MedicaidTX
8DF513OtherTXBCBS
P01170938OtherTXRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120515000377 TX Practitioner - Orthopedic Surgery 4981867710 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Howard University College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5303 Harry Hines Blvd
FL 6
Dallas, TX 75390-7208
Phone (214) 645-2020

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57.010466OHMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas Orthopaedic Surgery CurrentSince Mar 1, 2019 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Mar 1, 2019 Accepting new patients
Acclaim Physician Group, Inc CurrentSince May 1, 2016 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients

Locations

1801 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2035

2350 N Stemmons Fwy
Dallas, TX 75207
Phone (469) 488-7100

5303 Harry Hines Blvd
Fl 6
Dallas, TX 75390
Phone (214) 645-2225

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

1350 S Main St
Fl 1
Fort Worth, TX 76104
Phone (817) 702-3701

Organizations & group practices 4

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.

Hospital & facility affiliations 45

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

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373241600000",
    "number": "1093918245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99335",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761990335",
            "telephone_number": "817-735-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 MONTGOMERY ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761072553",
            "telephone_number": "817-735-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKSON",
        "first_name": "DOUGLAS",
        "middle_name": "DARKO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2013-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OH",
            "license": "57.010466",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "P1746",
            "primary": true
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "TX",
            "license": "P1746",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "296488401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8DF513",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01170938",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.