Individual provider Active NPI

Douglas R. Baker, M.D.

  • Diagnostic Radiology Physician
  • Fort Worth, TX
National Provider Identifier
1326047713
Registry record updated May 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
L1799 Issued in TX
Practice address
815 Pennsylvania Ave
Fort Worth, TX 76104-2224
Phone
(817) 321-0312
Fax
(817) 317-7033
NPI assigned
Jul 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X L1799 TX
Diagnostic Ultrasound Physician 2085U0001X L1799 TX
Diagnostic Radiology Physician 2085R0202X L1799 TX Primary

Addresses

Primary practice location

815 Pennsylvania Ave
Fort Worth, TX 76104-2224

Mailing address

815 Pennsylvania Ave
Fort Worth, TX 76104-2224
Phone (817) 321-0404

Other identifiers 3

IdentifierTypeStateIssuer
1427304-05MedicaidTX
142730401MedicaidTX
142730402MedicaidTX

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
I20031211000728 TX Practitioner - Diagnostic Radiology 8820994536 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L1799TXMDBody Imaging Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Imaging of Grapevine/Colleyville, LLC CurrentSince Oct 1, 2024 Accepting new patients
Preferred Imaging of Plano, LLC CurrentSince Oct 1, 2024 Accepting new patients
Preferred Imaging of McKinney, LLC Diagnostic Radiology CurrentSince Apr 4, 2023 Accepting new patients
Preferred Imaging of Irving LLC Diagnostic Radiology CurrentSince Sep 14, 2024 Accepting new patients
Round Rock Imaging LLC CurrentSince Oct 1, 2024 Accepting new patients
Preferred Open MRI, LLC Diagnostic Radiology CurrentSince Oct 1, 2024 Accepting new patients
Akumin Imaging Texas LLC CurrentSince Oct 1, 2024 Accepting new patients
Preferred Imaging of Frisco, LLC Diagnostic Radiology CurrentSince Oct 1, 2024 Accepting new patients
Radiology Associates of North Texas PA Body Imaging CurrentSince Mar 1, 2011 Accepting new patients
Radiology Associates of North Texas PA Body Imaging CurrentSince Mar 1, 2011 Accepting new patients
Indiana University Radiology Associates, Inc. Diagnostic Radiology Past Accepting new patients
Clinical Care in Radiology Past Accepting new patients

Locations

17980 Dallas Pkwy
Ste 200
Dallas, TX 75287
Phone (972) 248-1303

11970 N Central Expy
Ste 100
Dallas, TX 75243
Phone (469) 248-1000

815 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 321-0300

816 W Cannon St
Ft Worth, TX 76104
Phone (817) 321-0312

Organizations & group practices 12

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": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590624000000",
    "number": "1326047713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 PENNSYLVANIA AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042224",
            "telephone_number": "817-321-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 PENNSYLVANIA AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042224",
            "telephone_number": "817-321-0312",
            "fax_number": "817-317-7033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "DOUGLAS",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "TX",
            "license": "L1799",
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "TX",
            "license": "L1799",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "L1799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427304-05",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142730401",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142730402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.