Individual provider Active NPI

Courtney R Roberts, MD

  • Anesthesiology Physician
  • Dallas, TX
National Provider Identifier
1629033576
Registry record updated Jun 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
Q8782 Issued in TX
Practice address
12222 Merit Dr Ste 600
Dallas, TX 75251-3294
Phone
(972) 715-5000
Fax
(972) 715-9976
NPI assigned
Apr 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X PENDING OK
Anesthesiology Physician 207L00000X Q8782 TX Primary

Addresses

Primary practice location

12222 Merit Dr Ste 600
Dallas, TX 75251-3294

Mailing address

PO Box 840853
Dallas, TX 75284-0853
Phone (972) 233-1999

Other practice location 1

6606 Lyndon B Johnson Fwy Ste 200
Dallas, TX 75240-6524
Phone (972) 233-1999

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidOK

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
I20191119002716 TX Practitioner - Anesthesiology 6709898901 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
U S Anesthesia Partners of Texas, PAGroup PAC ID 7315850351, 2,750 clinicians
Oxford Physical Therapy and RehabilitationGroup PAC ID 0244232874, 432 clinicians

Practice addresses (Care Compare)

2700 E Broad St
Greater Houston Anesthesiology
Mansfield, TX 76063-5899
Phone (682) 242-6440

7567 Central Parke Blvd
Mason, OH 45040-6852

Hospital & facility affiliations

  • Baylor Scott and White Orthopedic and Spine Hospi Hospital, Arlington, TX, CCN 670067
  • Methodist Mansfield Medical Center Hospital, Mansfield, TX, CCN 670023
  • Methodist Midlothian Medical Center Hospital, Midlothian, TX, CCN 670300

Merit-based Incentive Payment System (MIPS)

Final score
88.94 of 100Reported as group
Quality
91.31
Improvement activities
40
Cost
79.05

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PENDINGOKMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
U. S. Anesthesia Partners of Texas, P.a., Anesthesiology CurrentSince Nov 1, 2019 Accepting new patients
U S Anesthesia Partners of Texas, PA Anesthesiology CurrentSince Nov 1, 2019 Accepting new patients

Locations

12222 Merit Dr
Ste 600
Dallas, TX 75251
Phone (972) 361-1844

6606 Lyndon B Johnson Fwy
Ste 200
Dallas, TX 75240
Phone (682) 885-4054

1800 Park Place Ave
Ft Worth, TX 76110
Phone (682) 703-5600

5615 Kirby Dr
Ste 850
Houston, TX 77005

100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555

2700 E Broad St
Mansfield, TX 76063
Phone (682) 242-2000

9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300

Interoperability endpoints

  • Direct secure messaging: croberts1538063@direct.texashealth.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 3

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": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1629033576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840853",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840853",
            "telephone_number": "972-233-1999",
            "fax_number": "972-233-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12222 MERIT DR STE 600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752513294",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6606 Lyndon B Johnson Fwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752406524",
            "country_code": "US",
            "telephone_number": "972-233-1999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "COURTNEY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "PENDING",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "Q8782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.