Individual provider Active NPI

Cynthia Michelle Roger, RN MSN

  • Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1548469141
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
639647 Issued in TX
Practice address
1201 Fairmount Ave
Fort Worth, TX 76104-4215
Phone
(817) 335-5288
Fax
(817) 338-0927
NPI assigned
Jul 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 639647 TX Primary

Addresses

Primary practice location

1201 Fairmount Ave
Fort Worth, TX 76104-4215

Mailing address

601 Omega Dr Ste 208
Arlington, TX 76014-2075
Phone (817) 465-5881

Other identifiers 1

IdentifierTypeStateIssuer
192314601MedicaidTX

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071115000522 TX Practitioner - Nurse Practitioner 3476641002 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Texas Pulmonary and Critical Care Consultants PAGroup PAC ID 0840198818, 57 clinicians

Practice addresses (Care Compare)

1201 Fairmount Ave
Fort Worth, TX 76104-4215
Phone (817) 335-5288

Hospital & facility affiliations

  • Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135
  • Cook Childrens Medical Center Hospital, Fort Worth, TX, CCN 453300
  • Texas Health Harris Methodist Hospital Azle Hospital, Azle, TX, CCN 450419

Merit-based Incentive Payment System (MIPS)

Final score
92.25 of 100Reported as group
Promoting interoperability
85
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Tarrant Pulmonary Associates LLC CurrentSince Nov 1, 2022 Accepting new patients
Texas Pulmonary & Critical Care Consultants, PA CurrentSince Oct 1, 2007 Accepting new patients
Texas Pulmonary & Critical Care Consultants, PA PastSince Oct 1, 2007 Accepting new patients

Locations

601 Omega Dr
Ste 208
Arlington, TX 76014
Phone (817) 465-5881

1201 Fairmount Ave
Fort Worth, TX 76104
Phone (817) 335-5288

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

1521 Cooper St
Ft Worth, TX 76104
Phone (817) 336-5864

Interoperability endpoints

  • Direct secure messaging: croger56599@cookchildrens.direct-ci.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/BHHJCD
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72070

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": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1548469141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 OMEGA DR STE 208",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760142075",
            "telephone_number": "817-465-5881",
            "fax_number": "817-465-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 FAIRMOUNT AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044215",
            "telephone_number": "817-335-5288",
            "fax_number": "817-338-0927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGER",
        "first_name": "CYNTHIA",
        "middle_name": "MICHELLE",
        "credential": "RN MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-13",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "639647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "192314601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.