Individual provider Active NPI

Brian Keith Carlile, DO

  • Anatomic Pathology & Clinical Pathology Physician
  • Fort Worth, TX
National Provider Identifier
1780658211
Registry record updated Jan 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
L6816 Issued in TX
Practice address
1400 8TH Avenue
Fort Worth, TX 76104-4192
Phone
(817) 927-6249
NPI assigned
Feb 13, 2006
Last updated
Jan 7, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X L6816 TX Primary

Addresses

Primary practice location

1400 8TH Avenue
Fort Worth, TX 76104-4192

Mailing address

2124 Pembroke Dr
Fort Worth, TX 76110-1218
Phone (817) 922-1559

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
I20040206000608 TX Practitioner - Pathology 3870486301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of North Texas HSC, College of Osteopathic Med, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tarrant Pathology AssociatesGroup PAC ID 5890680433, 5 clinicians

Practice addresses (Care Compare)

1400 8TH Ave
Fort Worth, TX 76104-4110
Phone (817) 922-1559

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.22 of 100Reported as group
Quality
80
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tarrant Pathology Associates Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2003 Accepting new patients

Locations

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

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

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 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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199664000000",
    "number": "1780658211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 PEMBROKE DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761101218",
            "telephone_number": "817-922-1559",
            "fax_number": "817-927-6296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 8TH AVENUE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044192",
            "telephone_number": "817-927-6249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLILE",
        "first_name": "BRIAN",
        "middle_name": "KEITH",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2008-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "L6816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.