Adeka D McIntosh, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

Q0507 Issued in TX

Practice address

816 W Cannon St
9TH Floor
Fort Worth, TX 76104-3146

Phone

(817) 321-0387

NPI assigned

Jan 19, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX, FL2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• North Star Diagnostic Imaging, LLC

  • Radiology Clinic/Center
  • Plano, TX
  • NPI 1467787739
  Medicare reassignment NPD
• Radiology Associates of North Texas PA

  • Diagnostic Radiology Physician
  • Fort Worth, TX
  • NPI 1710970975

  Pediatric Radiology

  Medicare reassignment NPD
• The Nemours Foundation

  • Multi-Specialty Clinic/Center
  • Jacksonville, FL
  • NPI 1386658615
  Medicare reassignment NPD
• Radiology Associates of North Texas, PA

  • Diagnostic Radiology Physician
  • Fort Worth, TX
  • NPI 1861782740
  NPD
• The Nemours Foundation

  • Multi-Specialty Clinic/Center
  • Jacksonville, FL
  • NPI 1265585806
  NPD
• The Nemours Foundation

  • Children's Hospital
  • Wilmington, DE
  • NPI 1467505073
  NPD
• Clinical Care in Radiology

  • Physician Assistant
  • Fort Worth, TX
  • NPI 1578331393
  NPD (past)
• Childrens Health Care Associates of New Jersey PC

  • Pediatrics Physician
  • Voorhees, NJ
  • NPI 1427152917
  NPD (past)
• Nemours New Jersey Physician Practice, P.C.

  • Pediatrics Physician
  • Deptford, NJ
  • NPI 1265874713
  NPD (past)

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1376696658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 W CANNON ST",
            "address_2": "9TH FLOOR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043146",
            "telephone_number": "817-321-0387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 W CANNON ST",
            "address_2": "9TH FLOOR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043146",
            "telephone_number": "817-321-0387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTOSH",
        "first_name": "ADEKA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "PA",
            "license": "MD438111",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "PA",
            "license": "MD438111",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "Q0507",
            "primary": true
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "TX",
            "license": "Q0507",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TX",
            "license": "Q0507",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121715008",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "285250104",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121715004",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Serra McGuire, MPAS, PA-C
• Christina Leigh McGuyer, CPNP-AC
• Dustin McHalffey, CNIM
• Ashley Rose McHattie, RN
• McIntosh Dental Services, PC
• Austin McIntosh
• James Andrew McIntosh, DNP-A, CRNA
• Liberty McIntosh
• Sheri McIntosh, D.D.S
• William E McIntosh, DO

• Diagnostic Radiology Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Diagnostic Radiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.