Individual provider Active NPI

Keith C. Watson, M.D.

  • Orthopaedic Surgery Physician
  • Fort Worth, TX
National Provider Identifier
1417981580
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
E2923 Issued in TX
Practice address
5900 Altamesa Blvd Ste 100
Fort Worth, TX 76132-5473
Phone
(817) 854-9969
Fax
(817) 854-9965
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X E2923 TX Primary

Addresses

Primary practice location

5900 Altamesa Blvd Ste 100
Fort Worth, TX 76132-5473

Mailing address

8210 Walnut Hill LN Ste 130
Dallas, TX 75231-4418
Phone (214) 750-1207

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
I20090323000040 TX Practitioner - Orthopedic Surgery 3678653920 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Texas Southwestern Medical School at Dallas, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Green Oaks Physical Therapy Limited PartnershipGroup PAC ID 4688582141, shared by 2 NPIs, 208 clinicians
Ortholonestar PLLCGroup PAC ID 9931529062, 416 clinicians

Practice addresses (Care Compare)

350 Mercedes St
Benbrook, TX 76126-2593
Phone (817) 717-5390

3800 Gaylord Pkwy
Suite 710
Frisco, TX 75034-9635
Phone (214) 220-2468

7115 Greenville Ave
Suite 310
Dallas, TX 75231-5103
Phone (214) 265-3200

721 Keller Pkwy
Keller, TX 76248-2404
Phone (817) 854-9969

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.26 of 100Reported as individual
Quality
97.39
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)55

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ortholonestar, PLLC Orthopaedic Surgery CurrentSince Oct 1, 2020 Accepting new patients
Ortholonestar, PLLC Orthopaedic Surgery CurrentSince Oct 1, 2020 Accepting new patients
Ortholonestar, PLLC Orthopaedic Surgery Past Accepting new patients

Locations

8210 Walnut Hill Ln
Ste 130
Dallas, TX 75231
Phone (214) 750-1207

5900 Altamesa Blvd
Ste 100
Fort Worth, TX 76132
Phone (817) 854-9969

3800 Gaylord Pkwy
Ste 710
Frisco, TX 75034

5701 Bryant Irvin Rd
Ste 202
Ft Worth, TX 76132
Phone (817) 263-1800

721 Keller Pkwy
Ste 107B
Keller, TX 76248
Phone (817) 741-8020

Interoperability endpoints

  • Direct secure messaging: keith.watson.1@15533.direct.athenahealth.com

Organizations & group practices 3

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 5

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1417981580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8210 WALNUT HILL LN STE 130",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314418",
            "telephone_number": "214-750-1207",
            "fax_number": "214-750-8504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 ALTAMESA BLVD STE 100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761325473",
            "telephone_number": "817-854-9969",
            "fax_number": "817-854-9965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "KEITH",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "E2923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.