Ethan Boothe, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

Q2741 Issued in TX

Practice address

815 Pennsylvania Ave
Fort Worth, TX 76104-2224

Phone

(817) 321-0404

NPI assigned

Apr 10, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, OK, AR, NM, LA, MS6 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 6

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.

• Crawford Andrews & Davis PTR

  • Diagnostic Radiology Physician
  • Beaumont, TX
  • NPI 1952325573

  Diagnostic Radiology, TX

  Medicare reassignment Care Compare group NPD
• Ochsner Clinic LLC

  • General Practice Physician
  • New Orleans, LA
  • NPI 1538151428

  LA

  Medicare reassignment Care Compare group NPD
• Radiology Associates of North Texas PA

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

  AR, NM, OK, TX

  Medicare reassignment Care Compare group
• University of Texas Southwestern Medical Center at Dallas

  • Anesthesiology Physician
  • Dallas, TX
  • NPI 1942270566

  TX

  Medicare reassignment NPD
• Ochsner Mississippi, LLC

  • Internal Medicine Physician
  • Bay Saint Louis, MS
  • NPI 1538674239

  MS

  Medicare reassignment NPD
• Ochsner Clinic LLC

  • Registered Dietitian
  • Covington, LA
  • NPI 1013747039
  Care Compare group NPD
• Ochsner Clinic LLC

  • General Practice Physician
  • Hattiesburg, MS
  • NPI 1962796789
  Care Compare group
• Center for Molecular Imaging Limited Partnership

  • Radiology Clinic/Center
  • Dallas, TX
  • NPI 1568468676
  NPD
• Health Imaging Partners LLC

  • Physiological Laboratory
  • Denton, TX
  • NPI 1417414822

  Diagnostic Radiology

  NPD
• Health Imaging Partners LLC

  • Physiological Laboratory
  • Fort Worth, TX
  • NPI 1649753716

  Diagnostic Radiology

  NPD
• Health Imaging Partners LLC

  • Physiological Laboratory
  • Keller, TX
  • NPI 1861358061

  Diagnostic Radiology

  NPD
• Health Imaging Partners LLC

  • Physiological Laboratory
  • Flower Mound, TX
  • NPI 1942081153

  Diagnostic Radiology

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Christus Good Shepherd Medical Center

  • General Acute Care Hospital
  • Longview, TX
  • NPI 1124092036

  Hospital

  Care Compare affiliation
• Christus Health Ark-la-Tex

  • General Practice Physician
  • Texarkana, TX
  • NPI 1184623266

  Hospital

  Care Compare affiliation
• Christus Health Ark-la-Tex

  • General Acute Care Hospital
  • Texarkana, TX
  • NPI 1295736734

  Hospital

  Care Compare affiliation
• Hillcrest Baptist Medical Center

  • General Acute Care Hospital
  • Waco, TX
  • NPI 1891882833

  Hospital

  Care Compare affiliation
• Mother Frances Hospital Regional Health Care Center

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1679578439

  Hospital

  Care Compare affiliation
• Tarrant County Hospital District

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1992753222

  Hospital

  Care Compare affiliation

Specialty

Diagnostic Radiology

Education

Louisiana State University School of Medicine in Shreveport, 2013

Medicare assignment

May accept Medicare assignment

Group practices

Radiology Associates of North Texas PA 340 clinicians

Ochsner Clinic LLC 2,845 clinicians

Crawford Andrews and Davis PTR 47 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• JPS Health Network Hospital, Fort Worth, TX, CCN 450039
• Christus St Michael Health System Hospital, Texarkana, TX, CCN 450801
• Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102
• Christus Good Shepherd Medical Center Hospital, Longview, TX, CCN 450032
• Baylor Scott & White Medical Center Hillcrest Hospital, Waco, TX, CCN 450101

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

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

{
    "created_epoch": "1365552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1508209495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 W CANNON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043146",
            "telephone_number": "173-210-9378",
            "fax_number": "504-842-7806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 PENNSYLVANIA AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042224",
            "telephone_number": "817-321-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTHE",
        "first_name": "ETHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-10",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "Q2741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melchor Menchaca Boone Jr., MD
• Thanapoom Boonipat
• Hilary Park Booth, NP
• L. Michelle Booth, M.D.
• Michael H Boothby, M.D.
• Jimmie Floyd Booze
• Janice Carolyn Boozer, RN ANP MSN
• Larry Boozer
• Kelly V Bora, MD
• Nelson Borchardt, DPT

• All providers in Fort Worth, TX
• Diagnostic Radiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.