Individual provider Active NPI

Trisha Elizebeth Smith, M.D.

  • Family Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1255359360
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K6716 Issued in TX
Practice address
855 Montgomery St
Fort Worth, TX 76107-2553
Phone
(817) 735-5051
Fax
(817) 735-0651
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X K6716 TX Primary

Addresses

Primary practice location

855 Montgomery St
Fort Worth, TX 76107-2553

Mailing address

PO Box 99335
Fort Worth, TX 76199-3300
Phone (877) 331-4113

Other identifiers 3

IdentifierTypeStateIssuer
85491XOtherTXBCBS
045545302MedicaidTX
045545301MedicaidTX

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
I20100330000718 TX Practitioner - Family Practice 5890821755 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of North Texas Health Science Center at Fort Worth Family Medicine CurrentSince Nov 1, 2022 Accepting new patients
University of North Texas Health Science Center at Fort Worth Current Accepting new patients
Healthtexas Provider Network CurrentSince Feb 28, 2000 Accepting new patients
University of North Texas Health Science Center at Fort Worth Current Accepting new patients
University of North Texas Health Science Center at Fort Worth Family Medicine Current Accepting new patients
University of North Texas Health Science Center at Fort Worth CurrentSince Nov 1, 2022 Accepting new patients
Healthtexas Provider Network Family Medicine CurrentSince Feb 28, 2000 Accepting new patients
University of North Texas Health Science Center at Fort Worth Family Medicine Past Accepting new patients

Locations

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

7350 University Hills Blvd
Ste 26
Dallas, TX 75241
Phone (972) 338-1793

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

855 Montgomery St
Fl 4
Fort Worth, TX 76107
Phone (817) 735-2400

3430 Camp Bowie Blvd
Fl 1
Fort Worth, TX 76107
Phone (817) 735-5051

855 Montgomery St
Ft Worth, TX 76107
Phone (817) 735-2334

2900 Village Pkwy
Ste 300
Highland Village, TX 75077
Phone (469) 800-0500

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

Interoperability endpoints

  • Direct secure messaging: 2373-smith-trisha@direct.leadingreach.com
  • Direct secure messaging: trisha.smith.d1.p1@direct.unthsc.nextgenshare.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1255359360",
    "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": "761993300",
            "telephone_number": "877-331-4113",
            "fax_number": "877-331-4118"
        },
        {
            "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": "817-735-5051",
            "fax_number": "817-735-0651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TRISHA",
        "middle_name": "ELIZEBETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K6716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "85491X",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "045545302",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "045545301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.