Individual provider Active NPI

Dustin Lee Taliaferro, DO

  • Emergency Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1568959286
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
S3466 Issued in TX
Practice address
6451 Brentwood Stair Rd Ste 200
Fort Worth, TX 76112-3200
Phone
(817) 496-9700
NPI assigned
Apr 18, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X S3466 TX Primary

Addresses

Primary practice location

6451 Brentwood Stair Rd Ste 200
Fort Worth, TX 76112-3200

Mailing address

2180 Bennett Ave Apt 202
Dallas, TX 75206-6925
Phone (903) 343-3345

Other practice location 1

5323 Harry Hines Blvd
Dallas, TX 75390-7201
Phone (214) 648-3916

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
I20210429001933 TX Practitioner - Emergency Medicine 3274942420 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Medicine Resources, LLPGroup PAC ID 5890688212, 255 clinicians

Practice addresses (Care Compare)

6200 W Parker Rd
Plano, TX 75093-8185
Phone (972) 981-8000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Acs Primary Care Physicians Southwest, PA Emergency Medicine CurrentSince Jul 28, 2021 Accepting new patients
Texas Medicine Resources, LLP Emergency Medicine CurrentSince Mar 1, 2021 Accepting new patients
Century Integrated Partners, Inc Emergency Medicine CurrentSince May 3, 2023 Accepting new patients

Locations

1105 Central Expy N
Allen, TX 75013
Phone (972) 747-4313

8200 Walnut Hill Ln
Dallas, TX 75231
Phone (214) 345-6148

3500 Gaston Ave
Dallas, TX 75246

6451 Brentwood Stair Rd
Ste 200
Ft Worth, TX 76112
Phone (817) 496-9700

1301 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 250-2000

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

5252 W University Dr
McKinney, TX 75071
Phone (469) 764-1000

4700 Alliance Blvd
#P
Plano, TX 75093
Phone (469) 814-2000

6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000

Interoperability endpoints

  • Direct secure messaging: dtaliaferro74089@direct.phhs.org

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": "1524009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1568959286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 BENNETT AVE APT 202",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752066925",
            "telephone_number": "903-343-3345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6451 BRENTWOOD STAIR RD STE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761123200",
            "telephone_number": "817-496-9700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5323 Harry Hines Blvd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "753907201",
            "country_code": "US",
            "telephone_number": "214-648-3916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TALIAFERRO",
        "first_name": "DUSTIN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-18",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "S3466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.