Individual provider Active NPI

Mauricio Ernesto Smart, M.D.

  • Pediatrics Physician
  • Fort Worth, TX
National Provider Identifier
1104195379
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
P8416 Issued in TX
Practice address
801 7TH Ave
Fort Worth, TX 76104-2733
Phone
(682) 885-1024
Fax
(682) 885-1033
NPI assigned
Dec 18, 2011
Last updated
Sep 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X P8416 TX
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X P8416 TX
Pediatrics Physician 208000000X P8416 TX Primary

Addresses

Primary practice location

801 7TH Ave
Fort Worth, TX 76104-2733

Mailing address

PO Box 99213
Fort Worth, TX 76199-0213
Phone (682) 885-4444

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20141029001120 TX Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 4082835392 Reassigns benefits to 6 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P8416TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children's Physician Network Pediatrics CurrentSince Nov 1, 2016 Accepting new patients
Nueces Emergency Medicine Associates PA Emergency Medicine CurrentSince Jan 2, 2022 Accepting new patients
Barrier Reef Emergency Physicians PLLC Emergency Medicine CurrentSince Feb 1, 2023 Accepting new patients
Memorial Hermann Hospital Based Physician Group Emergency Medicine CurrentSince Aug 1, 2021 Accepting new patients
Acs Primary Care Physicians Southwest, PA Emergency Medicine CurrentSince Jul 1, 2014 Accepting new patients
Cook Children's Physician Network Pediatric Emergency Medicine CurrentSince Nov 1, 2016 Accepting new patients
Cook Children's Physician Network Pediatrics Current Accepting new patients
Singleton Associates PA Past Accepting new patients

Locations

3533 S Alameda St
Corpus Christi, TX 78411
Phone (361) 694-5445

27800 NW Freeway
Cypress, TX 77433
Phone (346) 231-4000

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

921 Gessner Rd
Houston, TX 77024
Phone (713) 242-3439

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

6316 Precinct Line Rd
Hurst, TX 76054
Phone (817) 605-2500

23900 Katy Fwy
Katy, TX 77494
Phone (281) 644-7000

2555 Gulf Fwy S
#C1100
League City, TX 77573

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

16100 South Fwy
Pearland, TX 77584
Phone (713) 413-5000

9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300

9250 Pinecroft Dr
#C
Shenandoah, TX 77380

17500 W Grand Pkwy S
Sugar Land, TX 77479
Phone (281) 725-5000

200 Blossom St
Webster, TX 77598
Phone (281) 252-7000

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1324166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1104195379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99213",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761990213",
            "telephone_number": "682-885-4444",
            "fax_number": "817-810-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 7TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042733",
            "telephone_number": "682-885-1024",
            "fax_number": "682-885-1033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMART",
        "first_name": "MAURICIO",
        "middle_name": "ERNESTO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-18",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "P8416",
            "primary": false
        },
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "TX",
            "license": "P8416",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P8416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.