Individual provider Active NPI

Baker Mays Roberson

  • Certified Registered Nurse Anesthetist
  • Fort Worth, TX
National Provider Identifier
1801501432
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1107916 Issued in TX
Practice address
1400 8TH Ave
Fort Worth, TX 76104-4110
Phone
(817) 926-2544
NPI assigned
Jan 18, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1107916 TX Primary
Registered Nurse 163W00000X 914997 TX

Addresses

Primary practice location

1400 8TH Ave
Fort Worth, TX 76104-4110

Mailing address

3105 Spotted Fawn Dr
Fort Worth, TX 76108-1444
Phone (817) 694-3541

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230310001922 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 0840663910 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia III PAGroup PAC ID 0042630501, 393 clinicians

Practice addresses (Care Compare)

1400 8TH Ave
Fort Worth, TX 76104-4110
Phone (817) 926-2544

Hospital & facility affiliations

  • Medical City Fort Worth Hospital, Fort Worth, TX, CCN 450672
  • Baylor Scott and White All Saints Medical Center Hospital, Fort Worth, TX, CCN 450137
  • Baylor Scott & White Heart & Vascular Hospital - Dallas Hospital, Dallas, TX, CCN 450851

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
914997TXMDRegistered Nurse
1107916TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Medical Associates, PLLC. CurrentSince Jun 20, 2023 Accepting new patients
Northstar Anesthesia, PA Nurse Anesthetist, Certified Registered CurrentSince Mar 27, 2023 Accepting new patients
Minerva Labs LLC CurrentSince Mar 30, 2025 Accepting new patients
Northstar Anesthesia III PA Nurse Anesthetist, Certified Registered CurrentSince Feb 27, 2023 Accepting new patients

Locations

3315 S Alameda St
Corpus Christi, TX 78411
Phone (361) 761-1400

621 N Hall St
Dallas, TX 75226
Phone (214) 820-0600

7115 Greenville Ave
Dallas, TX 75231
Phone (214) 369-7115

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

909 9th Ave
Ft Worth, TX 76104
Phone (817) 336-6060

750 13th Ave
Ft Worth, TX 76104
Phone (817) 334-5050

1917 Ashland St
Houston, TX 77008
Phone (713) 861-6161

6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000

1203 S White Chapel Blvd
Ste 150
Southlake, TX 76092
Phone (817) 333-9898

Organizations & group practices 4

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": "1674000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1801501432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 SPOTTED FAWN DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761081444",
            "telephone_number": "817-694-3541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 8TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044110",
            "telephone_number": "817-926-2544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "BAKER",
        "middle_name": "MAYS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-18",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "1107916",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "914997",
            "primary": false
        }
    ],
    "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 Apr 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.