Individual provider Active NPI

Taylor Evan Crist

  • Plastic and Reconstructive Surgery Physician
  • Fort Worth, TX
National Provider Identifier
1578068805
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
W0548 Issued in TX
Practice address
800 8TH Ave Ste 206
Fort Worth, TX 76104-2619
Phone
(817) 529-9199
NPI assigned
Mar 28, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery of the Hand (Plastic Surgery) Physician 2082S0105X W0548 TX
Plastic and Reconstructive Surgery Physician 2086S0122X W0548 TX Primary

Addresses

Primary practice location

800 8TH Ave Ste 206
Fort Worth, TX 76104-2619

Mailing address

800 8TH Ave Ste 206
Fort Worth, TX 76104-2619
Phone (817) 529-9199

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
I20251011000006 TX Practitioner - Plastic and Reconstructive SurgeryPractitioner - Hand Surgery 8527555812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: Hand Surgery
Education
Eastern Virginia Medical School, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MP Plastic Surgery PLLCGroup PAC ID 1254681844, 9 clinicians

Practice addresses (Care Compare)

800 8TH Ave
Suite 206
Fort Worth, TX 76104-2619
Phone (817) 529-9199

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
W0548TXMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MP Plastic Surgery PLLC CurrentSince Sep 1, 2025 Accepting new patients

Locations

800 8th Ave
Ste 206
Fort Worth, TX 76104
Phone (817) 529-9199

Interoperability endpoints

  • Direct secure messaging: taylor.crist.1@29858.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1578068805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 8TH AVE STE 206",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042619",
            "telephone_number": "817-529-9199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 8TH AVE STE 206",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042619",
            "telephone_number": "817-529-9199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIST",
        "first_name": "TAYLOR",
        "middle_name": "EVAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-28",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "TX",
            "license": "W0548",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": "W0548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.