NPIMap

Individual provider Active NPI

Kevin Hoang, MD

  • Vascular & Interventional Radiology Physician
  • Fort Worth, TX
National Provider Identifier
1699204081
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
U3877 Issued in TX
Practice address
815 Pennsylvania Ave
Fort Worth, TX 76104-2224
Phone
(817) 321-0404
NPI assigned
Jun 8, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X A162300 CA
Vascular & Interventional Radiology Physician 2085R0204X U3877 TX Primary

Addresses

Primary practice location

815 Pennsylvania Ave
Fort Worth, TX 76104-2224

Mailing address

816 W Cannon St
Fort Worth, TX 76104-3146
Phone (817) 321-0404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX, MI3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20201029002202 CA Practitioner - Diagnostic Radiology 7113296807 Reassigns benefits to 1 organization
I20230706001218 TX Practitioner - Interventional Radiology 7113296807 Reassigns benefits to 1 organization
I20240119003736 MI Practitioner - Diagnostic Radiology 7113296807 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Iowa, RJ & L Carver College of Medicine, 2017
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

Detroit, MI 48207
Phone (817) 321-0404

2001 S Main St
Hope, AR 71801-8144
Phone (817) 321-0404

815 Pennsylvania Ave
Fort Worth, TX 76104-2224
Phone (817) 321-0470

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A162300CAMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Los Angeles Medical Group, Inc. CurrentSince Sep 26, 2020 Accepting new patients
Radiology Associates of North Texas PA Vascular & Interventional Radiology CurrentSince Aug 21, 2023 Accepting new patients
Clinical Care in Radiology Past Accepting new patients

Locations

2001 S Main St
Hope, AR 71801
Phone (870) 722-3800

3701 Wilshire Blvd
Ste 600
Los Angeles, CA 90010
Phone (323) 361-3550

4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122

17980 Dallas Pkwy
Ste 200
Dallas, TX 75287
Phone (972) 248-1303

816 W Cannon St
Ft Worth, TX 76104
Phone (817) 321-0312

815 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 321-0300

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 6

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": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1699204081",
    "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": "817-321-0404"
        },
        {
            "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": "HOANG",
        "first_name": "KEVIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-08",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "A162300",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TX",
            "license": "U3877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.