NPIMap

Individual provider Active NPI

Brendan W Reagan, MD

  • Interventional Cardiology Physician
  • Fort Worth, TX
National Provider Identifier
1275680076
Registry record updated Aug 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
P2158 Issued in TX
Practice address
1300 W Terrell Ave
Suite 500
Fort Worth, TX 76104-2820
Phone
(817) 252-5000
NPI assigned
Jan 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 42929 TN
Cardiovascular Disease Physician 207RC0000X P2158 TX
Interventional Cardiology Physician 207RI0011X P2158 TX Primary

Addresses

Primary practice location

1300 W Terrell Ave
Suite 500
Fort Worth, TX 76104-2820

Mailing address

1300 W Terrell Ave
Suite 500
Fort Worth, TX 76104-2820
Phone (817) 252-5000

Other identifiers 5

IdentifierTypeStateIssuer
0009880173OtherAETNA
305771301MedicaidTX
1506020MedicaidTN
7100051780OtherKYKENTUCKY MEDICAID
4190818OtherTNBCBST

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
I20120828000140 TX Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Other (Physician) 9133293467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Louisiana State University School of Medicine in New Orleans, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

1300 W Terrell Ave
Suite 500
Fort Worth, TX 76104-2821
Phone (817) 252-5000

Hospital & facility affiliations

  • Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135
  • Texas Health Harris Methodist Hospital Southwest F Hospital, Fort Worth, TX, CCN 450779
  • Texas Health Harris Methodist Hospital Stephenvill Hospital, Stephenville, TX, CCN 450351
  • Texas Health Harris Methodist Hospital Cleburne Hospital, Cleburne, TX, CCN 450148
  • Lake Granbury Medical Center Hospital, Granbury, TX, CCN 450596

Merit-based Incentive Payment System (MIPS)

Final score
83.54 of 100Reported as individual
Quality
66.1
Promoting interoperability
100
Improvement activities
40
Cost
73.76

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting37

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group Internal Medicine CurrentSince Aug 1, 2012 Accepting new patients
Texas Health Physicians Group CurrentSince Aug 1, 2012 Accepting new patients
Texas Health Physicians Group Current Accepting new patients
Children and Adults Medical Group, LLC Past Accepting new patients
Texas Health Physicians Group Internal Medicine Past Accepting new patients

Locations

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

4333 N Josey Ln
Ste 104
Carrollton, TX 75010
Phone (972) 394-4500

6100 Harris Pkwy
Ste 1200
Fort Worth, TX 76132
Phone (817) 263-3724

1300 W Terrell Ave
Ste 500
Ft Worth, TX 76104
Phone (817) 252-5000

341 Wheatfield Dr
Ste 100
Sunnyvale, TX 75182
Phone (972) 329-1996

Interoperability endpoints

  • Direct secure messaging: breagan192752@direct.texashealth.org

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 5

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408320000000",
    "number": "1275680076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W TERRELL AVE",
            "address_2": "SUITE 500",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042820",
            "telephone_number": "817-252-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W TERRELL AVE",
            "address_2": "SUITE 500",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042820",
            "telephone_number": "817-252-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAGAN",
        "first_name": "BRENDAN",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2014-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "42929",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "P2158",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "P2158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0009880173",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "305771301",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1506020",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENTUCKY MEDICAID",
            "identifier": "7100051780",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST",
            "identifier": "4190818",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.