Individual provider Active NPI

Caleb Smith, MD

  • Emergency Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1417488297
Registry record updated Jan 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
S0569 Issued in TX
Practice address
1500 S Main St
Fort Worth, TX 76104-4917
Phone
(817) 702-1173
NPI assigned
Mar 23, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X S0569 TX Primary

Addresses

Primary practice location

1500 S Main St
Fort Worth, TX 76104-4917

Mailing address

PO Box 392518
Pittsburgh, PA 15251-9518
Phone (469) 420-5544

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
I20200221002011 TX Practitioner - Emergency Medicine 6002243599 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Texas Tech University Health Science Center School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Em Alliance Texas PLLCGroup PAC ID 4587192430, 88 clinicians

Practice addresses (Care Compare)

1501 S Coulter St
NW TX Healthcare Sys
Amarillo, TX 79106-1770
Phone (561) 203-0611

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Acclaim Physician Group, Inc CurrentSince Feb 1, 2020 Accepting new patients
Nes Southwest Medical Services Inc Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
Em Alliance Texas, PLLC Emergency Medicine CurrentSince Nov 12, 2024 Accepting new patients
Truepartners Northwest Emergency Associates PLLC Emergency Medicine CurrentSince Jul 1, 2020 Accepting new patients
Integrative Emergency Services Physician Group PA Emergency Medicine CurrentSince Feb 1, 2020 Accepting new patients

Locations

4121 S Georgia St
Amarillo, TX 79110
Phone (561) 203-0611

8960 Hillside Rd
#N
Amarillo, TX 79119
Phone (806) 351-6987

8960 Hillside Rd
Amarillo, TX 79119
Phone (806) 351-6987

4207 W Amarillo Blvd
Amarillo, TX 79106
Phone (806) 351-7850

1501 S Coulter St
Amarillo, TX 79106
Phone (800) 354-1150

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

1575 S Main St
Ft Worth, TX 76104
Phone (817) 702-8828

1500 S Main St
Fl 1
Ft Worth, TX 76104
Phone (817) 702-1451

500 N Highland Ave
Sherman, TX 75092
Phone (903) 870-4494

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579564800000",
    "number": "1417488297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 392518",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152519518",
            "telephone_number": "469-420-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044917",
            "telephone_number": "817-702-1173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CALEB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-23",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "S0569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.