Active NPI
Brandon A Roberson, MD
- Physical Medicine & Rehabilitation Physician
- Fort Worth, TX
National Provider Identifier
1760064943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- W5943
- Practice address
- 2416 NW 18TH St
Fort Worth, TX 76106-6604 - Phone
- (872) 231-3162
- NPI assigned
- Apr 26, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | W5943 | TX | Primary |
Addresses
Primary practice location
2416 NW 18TH St
Fort Worth, TX 76106-6604
Mailing address
PO Box 74008272
Chicago, IL 60674-8272
Phone (872) 231-3162
Other practice location 1
355 Bard Avenue
Department of Medicine Villa Bldg 1st Floor
Staten Island, NY 10310
Phone (718) 818-2419
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Care Compare profile
Medicare Care Compare- Specialty
- Physical Medicine and Rehabilitation
- Education
- Rutgers, Robert Woood Johnson Medical School, 2021
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
4421 Florence Ave
Apt 1415
North Richland Hills, TX 76180-4404
PO Box
Chicago, IL 60674
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1619395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783382400000",
"number": "1760064943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 74008272",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606748272",
"telephone_number": "872-231-3162"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2416 NW 18TH ST",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761066604",
"telephone_number": "872-231-3162"
}
],
"practiceLocations": [
{
"address_1": "355 Bard Avenue",
"address_2": "Department of Medicine Villa Bldg 1st Floor",
"address_purpose": "LOCATION",
"city": "Staten Island",
"state": "NY",
"postal_code": "10310",
"country_code": "US",
"telephone_number": "718-818-2419",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROBERSON",
"first_name": "BRANDON",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-26",
"last_updated": "2026-07-07",
"certification_date": "2026-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "TX",
"license": "W5943",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.