Individual provider Active NPI

Raisa Nguyen Broadwell, MD

  • Anesthesiology Physician
  • Burleson, TX
National Provider Identifier
1275944282
Registry record updated Jul 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
R9114 Issued in TX
Practice address
11801 South Fwy
Burleson, TX 76028-7021
Phone
(817) 293-9110
NPI assigned
May 13, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X R9114 TX Primary
Anesthesiology Physician 207L00000X T-2831 MS

Addresses

Primary practice location

11801 South Fwy
Burleson, TX 76028-7021

Mailing address

6225 State Hwy 161 Ste 200
Irving, TX 75038-2241
Phone (214) 687-0001

Other names 1

  • Raisa Diones Nguyen Former name

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
I20181220002209 TX Practitioner - Anesthesiology 6608192893 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia III PAGroup PAC ID 0042630501, 393 clinicians

Practice addresses (Care Compare)

12001 S Fwy
Suite 101
Burleson, TX 76028-7214
Phone (817) 856-0655

Hospital & facility affiliations

  • Texas Health Huguley Hospital Fort Worth South Hospital, Fort Worth, TX, CCN 450677

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R9114TXMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia III PA Anesthesiology CurrentSince Apr 21, 2023 Accepting new patients
Northstar Anesthesia, PA Anesthesiology CurrentSince Oct 16, 2025 Accepting new patients

Locations

11801 South Fwy
Burleson, TX 76028
Phone (817) 551-2738

12001 South Fwy
Ste 101
Burleson, TX 76028
Phone (807) 615-4400

3315 S Alameda St
Corpus Christi, TX 78411
Phone (361) 761-1400

900 8th Ave
Ft Worth, TX 76104
Phone (817) 336-2100

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

909 9th Ave
Ft Worth, TX 76104
Phone (817) 336-6060

1917 Ashland St
Houston, TX 77008
Phone (713) 861-6161

6225 State Highway 161
Ste 200
Irving, TX 75038
Phone (214) 687-0496

6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000

Organizations & group practices 2

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 3

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": "1399939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785369600000",
    "number": "1275944282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6225 STATE HWY 161 STE 200",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382241",
            "telephone_number": "214-687-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11801 SOUTH FWY",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760287021",
            "telephone_number": "817-293-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADWELL",
        "first_name": "RAISA",
        "middle_name": "NGUYEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-13",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "R9114",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MS",
            "license": "T-2831",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAISA",
            "last_name": "NGUYEN",
            "middle_name": "DIONES",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Burleson, TX

Sources for this page

Verify at the official NPI Registry.