Michael Booth, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

S3124 Issued in TX

Practice address

2520 W I 20
Grand Prairie, TX 75052-7280

Phone

(722) 645-8589

Fax

(972) 264-8800

NPI assigned

Jun 6, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Family Practice

Education

University of Texas Medical School at Houston, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Primary Health Physicians PLLCGroup PAC ID 7810237740, 240 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Primary Health Physicians, PLLC

  • Urgent Care Clinic/Center
  • Denton, TX
  • NPI 1770048704
  Medicare reassignment Care Compare group NPD
• Impact Health Direct Primary Care, PLLC

  • Primary Care Clinic/Center
  • Ennis, TX
  • NPI 1760004188
  Medicare reassignment NPD
• Graybill Medical Group Inc

  • Family Medicine Physician
  • Escondido, CA
  • NPI 1891729745
  NPD (past)

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1184073629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 W I 20",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750527280",
            "telephone_number": "972-264-5858",
            "fax_number": "972-264-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 W I 20",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750527280",
            "telephone_number": "722-645-8589",
            "fax_number": "972-264-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-06",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "S3124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roseline J Boateng
• Precious Laquon Bolden
• Latuavia Bonner
• Darla R. Booker, M.A.
• David L Booker, PTA
• Samuel K Bore, LPC
• Maya Miko Botomani-Mposi, PA-C
• Zachary Q. Botone, MD
• Keana Bradley, LPC
• Patrick R Brady, D.D.S., M.S.

• Family Medicine Physician in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; 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.