Individual provider Active NPI

David Rothbart, MD

  • Neurological Surgery Physician
  • Southlake, TX
National Provider Identifier
1699709741
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
L3806 Issued in TX
Practice address
1545 E Southlake Blvd
Suite 100
Southlake, TX 76092
Phone
(817) 442-9300
Fax
(817) 416-0108
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X L3806 TX Primary

Addresses

Primary practice location

1545 E Southlake Blvd
Suite 100
Southlake, TX 76092

Mailing address

1545 E Southlake Blvd
Suite 100
Southlake, TX 76092-6422
Phone (817) 442-9300

Other identifiers 1

IdentifierTypeStateIssuer
B0122875OtherTXDPS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stt@116.direct.myezyaccess.com

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
I20040422001466 TX Practitioner - Neurosurgery 6709871999 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Texas Health Back CareGroup PAC ID 1951604313, 50 clinicians

Practice addresses (Care Compare)

3142 Horizon Rd
Suite 100
Rockwall, TX 75032-7815
Phone (817) 442-9300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion143
Laminectomy or laminotomy (partial removal of spine bones)42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L3806TXMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Back Care Neurological Surgery CurrentSince Jan 1, 2016 Accepting new patients
Texas Health Back Care Neurological Surgery Current Accepting new patients
Chicago Institute of Neurosurgery & Neuroresearch Neurological Surgery Past Accepting new patients

Locations

10900 Founders Way
Ste 100
Fort Worth, TX 76244
Phone (682) 651-1908

1340 S Main St
Ste 100
Grapevine, TX 76051
Phone (682) 651-1908

3509 Spectrum Blvd
#B
Richardson, TX 75082
Phone (972) 772-9600

3142 Horizon Rd
Ste 100
Rockwall, TX 75032
Phone (682) 651-1908

1545 E Southlake Blvd
Southlake, TX 76092
Phone (817) 557-8205

1545 E Southlake Blvd
Ste 100
Southlake, TX 76092

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1699709741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 E SOUTHLAKE BLVD",
            "address_2": "SUITE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926422",
            "telephone_number": "817-442-9300",
            "fax_number": "817-796-0763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 E SOUTHLAKE BLVD",
            "address_2": "SUITE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "76092",
            "telephone_number": "817-442-9300",
            "fax_number": "817-416-0108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHBART",
        "first_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2023-03-07",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TX",
            "license": "L3806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPS",
            "identifier": "B0122875",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stt@116.direct.myezyaccess.com",
            "affiliation": "N",
            "address_1": "1545 E Southlake Blvd",
            "address_2": "Suite 100",
            "city": "Southlake",
            "state": "TX",
            "country_code": "US",
            "postal_code": "76092",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

Verify at the official NPI Registry.