Individual provider Active NPI

Hayden Patrick Smith, DO

  • Physical Medicine & Rehabilitation Physician
  • Fort Worth, TX
National Provider Identifier
1366947004
Registry record updated Jul 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
S6050 Issued in TX
Practice address
5632 Edwards Ranch Rd Ste 100
Fort Worth, TX 76109-4149
Phone
(817) 336-7188
Fax
(844) 231-8865
NPI assigned
Mar 26, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X S6050 TX
Student in an Organized Health Care Education/Training Program 390200000X
Physical Medicine & Rehabilitation Physician 208100000X S6050 TX Primary

Addresses

Primary practice location

5632 Edwards Ranch Rd Ste 100
Fort Worth, TX 76109-4149

Mailing address

PO Box 226008
Dallas, TX 75222-6008

Other practice location 1

909 N Washington Ave
Dallas, TX 75246-1520
Phone (214) 820-9300

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
I20220720000524 TX Practitioner - Physical Medicine and Rehabilitation 9436530656 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5632 Edwards Ranch Rd
Suite 100
Fort Worth, TX 76109-4149
Phone (817) 336-7188

Hospital & facility affiliations

  • Medical City Fort Worth Hospital, Fort Worth, TX, CCN 450672
  • Medical City Fort Worth Inpatient rehabilitation facility, Fort Worth, TX, CCN 45T672

Merit-based Incentive Payment System (MIPS)

Final score
86.66 of 100Reported as individual
Quality
65
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
PM&R Fort Worth Clearfork PLLC Physical Medicine & Rehabilitation CurrentSince Aug 1, 2025 Accepting new patients
PM&R Fort Worth Central PLLC Physical Medicine & Rehabilitation CurrentSince Jul 1, 2022 Accepting new patients

Locations

5632 Edwards Ranch Rd
Ste 102
Fort Worth, TX 76109
Phone (817) 336-7188

5632 Edwards Ranch Rd
Ste 100
Ft Worth, TX 76109
Phone (817) 336-7188

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 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": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1366947004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 226008",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752226008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5632 EDWARDS RANCH RD STE 100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094149",
            "telephone_number": "817-336-7188",
            "fax_number": "844-231-8865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "909 N Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752461520",
            "country_code": "US",
            "telephone_number": "214-820-9300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "HAYDEN",
        "middle_name": "PATRICK",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-26",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "S6050",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "S6050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.