Individual provider Active NPI

Mitchell N Williams, DPM

  • Foot & Ankle Surgery Podiatrist
  • Fort Worth, TX
National Provider Identifier
1194990077
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
1852 Issued in TX
Practice address
1001 12TH Ave Ste 104
Fort Worth, TX 76104-3928
Phone
(682) 708-3300
Fax
(682) 708-3299
NPI assigned
Apr 23, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 1852 TX Primary
Foot & Ankle Surgery Podiatrist 213ES0103X 679 CO

Addresses

Primary practice location

1001 12TH Ave Ste 104
Fort Worth, TX 76104-3928

Mailing address

1001 12TH Ave Ste 104
Fort Worth, TX 76104-3928
Phone (682) 708-3300

Other identifiers 4

IdentifierTypeStateIssuer
1194990077OtherCORAILROAD MEDICARE
1720207863OtherCONPIGROUP
22572589MedicaidCO
1194990077OtherCONPI

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100217000121 TX Practitioner - Podiatry 6709958648 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1001 12TH Ave
Suite 104
Fort Worth, TX 76104-3928
Phone (817) 336-6600

Hospital & facility affiliations

  • Medical City Fort Worth Hospital, Fort Worth, TX, CCN 450672
  • Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135

Merit-based Incentive Payment System (MIPS)

Final score
99.82 of 100Reported as individual
Quality
95
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue74
Removal of skin lesions1-10
Removal of nail tissue200
Removal or shaving of skin growth50

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
1852TXMDFoot & Ankle Surgery Podiatrist
679COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Post Acute Specialists of Texas PA CurrentSince Aug 12, 2024 Accepting new patients
Foot and Ankle Associates of Fort Worth, PLLC Foot & Ankle Surgery CurrentSince Sep 6, 2023 Accepting new patients
Southwest Surgery and Wound Care Physicians Foot & Ankle Surgery CurrentSince Nov 25, 2019 Accepting new patients
Back Office Management Services LLC CurrentSince Apr 17, 2023 Accepting new patients
Back Office Management Services LLC CurrentSince Apr 17, 2023 Accepting new patients

Locations

2911 Medical Arts St
Ste 10
Austin, TX 78705
Phone (512) 474-5551

1001 12th Ave
Ste 104
Ft Worth, TX 76104
Phone (817) 336-6600

502 N Valley Pkwy
#2
Lewisville, TX 75067
Phone (972) 316-0902

4200 Shepherd Ln
Mesquite, TX 75180
Phone (972) 286-0335

434 Paza Dr
Mesquite, TX 75149
Phone (972) 286-6489

5804 Coit Rd
Ste 100
Plano, TX 75023
Phone (972) 424-3505

Interoperability endpoints

  • Direct secure messaging: mitwilliams@direct.uspi.com

Organizations & group practices 5

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 2

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": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1194990077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 12TH AVE STE 104",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043928",
            "telephone_number": "682-708-3300",
            "fax_number": "682-708-3299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 12TH AVE STE 104",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043928",
            "telephone_number": "682-708-3300",
            "fax_number": "682-708-3299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MITCHELL",
        "middle_name": "N",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-23",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "1852",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CO",
            "license": "679",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "1194990077",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPIGROUP",
            "identifier": "1720207863",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "22572589",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1194990077",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.