Theodore Sunao Takata, MD

Primary specialty

Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X

License

K8508 Issued in TX

Practice address

1300 W Terrell Ave
#500
Fort Worth, TX 76104-2800

Phone

(817) 252-5000

Fax

(817) 252-5060

NPI assigned

Oct 10, 2005

Last updated

Aug 15, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Specialty

Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)

Education

University of Maryland School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135
• Texas Health Harris Methodist Hospital Southwest F Hospital, Fort Worth, TX, CCN 450779

Merit-based Incentive Payment System (MIPS)

Final score

88.31 of 100Reported as individual

Quality

77.99

Promoting interoperability

99

Improvement activities

40

Cost

68.8

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ttakata26769@direct.texashealth.org

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.

• Texas Health Physicians Group

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1174573596
  Medicare reassignment Care Compare group NPD (past)
• Consultants in Cardiology, P.a.

  • Clinic/Center
  • Fort Worth, TX
  • NPI 1629104419
  NPD
• Texas Health Physicians Group

  dba Sleep Healers

  • Sleep Disorder Diagnostic Clinic/Center
  • Fort Worth, TX
  • NPI 1114395969
  NPD
• Texas Health Physicians Group

  dba Sleep Healers

  • Sleep Disorder Diagnostic Clinic/Center
  • Dallas, TX
  • NPI 1174992051
  NPD
• Texas Health Physicians Group

  • Internal Medicine Physician
  • Kaufman, TX
  • NPI 1992151740
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Texas Health Harris Methodist Hospital Fort Worth

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1336172105
  Care Compare affiliation
• Texas Health Harris Methodist Hospital Southwest Fort Worth

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1417980202
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313366400000",
    "number": "1801884382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W TERRELL AVE",
            "address_2": "#500",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042800",
            "telephone_number": "817-252-5000",
            "fax_number": "817-252-5060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W TERRELL AVE",
            "address_2": "#500",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042800",
            "telephone_number": "817-252-5000",
            "fax_number": "817-252-5060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKATA",
        "first_name": "THEODORE",
        "middle_name": "SUNAO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2011-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "TX",
            "license": "K8508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039267203",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "8M6142",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00226814",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039267205",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Cardiac Electrophysiology Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Clinical Cardiac Electrophysiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2011; 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.

Verify at the official NPI Registry.