Individual provider Active NPI

Reagan Michelle Street, MD

  • Gynecologic Oncology Physician
  • Fort Worth, TX
National Provider Identifier
1487845673
Registry record updated Oct 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
N3333 Issued in TX
Practice address
1001 12TH Ave
Suite 200
Fort Worth, TX 76104-3926
Phone
(817) 850-2000
Fax
(817) 850-2015
NPI assigned
Aug 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X N-3333 TX
Gynecologic Oncology Physician 207VX0201X N3333 TX Primary

Addresses

Primary practice location

1001 12TH Ave
Suite 200
Fort Worth, TX 76104-3926

Mailing address

PO Box 911230
Dallas, TX 75391-1230
Phone (972) 997-8000

Other identifiers 2

IdentifierTypeStateIssuer
204651802MedicaidTX
2766284705OtherMYUTMB 2766284705

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
I20090803000755 TX Practitioner - Obstetrics/GynecologyPractitioner - Gynecological Oncology 9335292663 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/GynecologyAlso: Gynecological Oncology
Education
Texas Tech University Health Science Center School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Oncology PAGroup PAC ID 5395658934, 1,001 clinicians

Practice addresses (Care Compare)

500 S Henderson St
Suite 300
Fort Worth, TX 76104-2154
Phone (817) 413-1500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.12 of 100Reported as apm
Quality
67.48
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N-3333TXMDObstetrics & Gynecology Physician
N3333TXMDGynecologic Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Utmb Faculty Group Practice Obstetrics & Gynecology CurrentSince Jul 20, 2009 Accepting new patients
Texas Oncology PA Gynecologic Oncology CurrentSince Aug 1, 2012 Accepting new patients
Texas Oncology PA Gynecologic Oncology CurrentSince Aug 1, 2012 Accepting new patients

Locations

1609 Hospital Pkwy
Bedford, TX 76022
Phone (817) 359-9000

4201 Brown Trl
Ste 101
Colleyville, TX 76034
Phone (682) 217-2102

7777 Forest Ln
Ste C707
Dallas, TX 75230
Phone (972) 566-3000

7848 Gateway Blvd E
El Paso, TX 79915
Phone (915) 599-1313

1001 12th Ave
Ste 200
Ft Worth, TX 76104
Phone (817) 850-2000

500 S Henderson St
Ste 300
Ft Worth, TX 76104
Phone (817) 413-1500

500 S Henderson St
Ste 200
Ft Worth, TX 76104
Phone (817) 413-1500

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

Interoperability endpoints

  • Direct secure messaging: reagan.street@txo.ikm.direct-ci.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 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": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349222400000",
    "number": "1487845673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 911230",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753911230",
            "telephone_number": "972-997-8000",
            "fax_number": "972-234-2987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 12TH AVE",
            "address_2": "SUITE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043926",
            "telephone_number": "817-850-2000",
            "fax_number": "817-850-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STREET",
        "first_name": "REAGAN",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-05",
        "last_updated": "2012-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "N-3333",
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "TX",
            "license": "N3333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204651802",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MYUTMB 2766284705",
            "identifier": "2766284705",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.