Individual provider Active NPI

Rudy Maeda Braza, M.D.

  • Diagnostic Radiology Physician
  • Texarkana, TX
National Provider Identifier
1790754497
Registry record updated Dec 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
N7232 Issued in TX
Practice address
4102 Richmond MDWS
Texarkana, TX 75503-0067
Phone
(903) 223-1014
NPI assigned
Mar 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X N7232 TX Primary

Addresses

Primary practice location

4102 Richmond MDWS
Texarkana, TX 75503-0067

Mailing address

PO Box 5667
Texarkana, TX 75505-5667
Phone (903) 223-1014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20101202000638 AR Practitioner - Diagnostic Radiology 3476646308 Reassigns benefits to 1 organization
I20101208000591 TX Practitioner - Diagnostic Radiology 3476646308 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Tufts University School of Medicine, 1997
Medicare assignment
May accept Medicare assignment
Group practices
Radiology Associates of North Texas PAGroup PAC ID 7911897301, 340 clinicians

Practice addresses (Care Compare)

805 Trinity Dr
Hope, AR 71801-3621
Phone (817) 321-0404

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

Hospital & facility affiliations

  • Christus St Michael Health System Hospital, Texarkana, TX, CCN 450801
  • Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102
  • Howard Memorial Hospital Hospital, Nashville, AR, CCN 041311

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
N7232TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates of North Texas PA Diagnostic Radiology CurrentSince Feb 27, 2023 Accepting new patients
Radiology Associates of North Texas, PA Diagnostic Radiology CurrentSince Feb 27, 2023 Accepting new patients

Locations

805 Trinity Dr
Hope, AR 71801
Phone (870) 722-1020

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

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

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

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

Organizations & group practices 2

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 4

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": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1790754497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5667",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755055667",
            "telephone_number": "903-223-1014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 RICHMOND MDWS",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755030067",
            "telephone_number": "903-223-1014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAZA",
        "first_name": "RUDY",
        "middle_name": "MAEDA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-15",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "N7232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

Verify at the official NPI Registry.