NPIMap

Organization Active NPI

Michael H Boothby, MD PA

Doing business as The Orthopedic and Sports Medicine Institute

  • Orthopaedic Surgery Physician
  • Fort Worth, TX
National Provider Identifier
1871878876
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
MICHAEL H BOOTHBY, MD PA
Doing business as
The Orthopedic and Sports Medicine Institute
Practice address
2901 Acme Brick PLZ
Fort Worth, TX 76109-4124
Phone
(817) 529-1900
Fax
(817) 529-1910
NPI assigned
Oct 21, 2011
Last updated
Nov 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Authorized official

Name
Dr. Michael H Boothby, MDNPI 1669419743
Title
Owner
Phone
(817) 529-1900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X Primary

Addresses

Primary practice location

2901 Acme Brick PLZ
Fort Worth, TX 76109-4124

Mailing address

2901 Acme Brick PLZ
Fort Worth, TX 76109-4124
Phone (817) 529-1900

Other identifiers 1

IdentifierTypeStateIssuer
297334901MedicaidTX

Other names 1

  • The Orthopedic and Sports Medicine Institute Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111230000081 TX Part B Supplier - Clinic/Group Practice 0446426134 Receives reassigned benefits from 14 practitioners
Practice locations: Decatur, TX; Fort Worth, TX; Mansfield, TX; Willow Park, TX; Aledo, TX

National Provider Directory

National Provider Directory

Locations

260 Willow Bend Dr
Ste 200
Aledo, TX 76008
Phone (817) 441-2555

1000 Medical Center Dr
Decatur, TX 76234
Phone (940) 539-8510

1851 Medical Center Dr
Decatur, TX 76234
Phone (940) 627-1768

6049 S Hulen St
Ste A
Fort Worth, TX 76132

305 Regency Pkwy
Ste 405
Mansfield, TX 76063
Phone (682) 518-1100

5480 E Highway 287
Midlothian, TX 76065
Phone 81752919002010

Interoperability endpoints

  • Direct secure messaging: bbeavers@direct.osmifw.com
  • Direct secure messaging: jcurtis@direct.osmifw.com
  • Direct secure messaging: kgill@direct.osmifw.com
  • Direct secure messaging: mboothby@direct.osmifw.com
  • Direct secure messaging: mlandon@direct.osmifw.com
  • Direct secure messaging: sshaw@direct.osmifw.com

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1319155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730851200000",
    "number": "1871878876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 ACME BRICK PLZ",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094124",
            "telephone_number": "817-529-1900",
            "fax_number": "817-529-1910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 ACME BRICK PLZ",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094124",
            "telephone_number": "817-529-1900",
            "fax_number": "817-529-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL H BOOTHBY, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-21",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A",
        "authorized_official_last_name": "BOOTHBY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-529-1900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "297334901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Orthopedic and Sports Medicine Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.