Individual provider Active NPI

James Gary Schroeder, MD

  • Diagnostic Radiology Physician
  • Dallas, TX
National Provider Identifier
1891759676
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
J4503 Issued in TX
Practice address
4320 Westway Ave
Dallas, TX 75205-3728
Phone
(214) 693-8134
NPI assigned
Apr 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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 J4503 TX Primary

Addresses

Primary practice location

4320 Westway Ave
Dallas, TX 75205-3728

Mailing address

4320 Westway Ave
Dallas, TX 75205-3728
Phone (214) 693-8134

Other identifiers 2

IdentifierTypeStateIssuer
047354801MedicaidTX
132136605MedicaidTX

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
I20061023000368 TX Practitioner - Diagnostic Radiology 5991702649 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J4503TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
BMB Associates LLC CurrentSince Aug 27, 2012 Accepting new patients
Specialty Imaging Consultants LLC Diagnostic Radiology CurrentSince Mar 6, 2022 Accepting new patients
Open MRI of Fort Worth, L.C. Past Accepting new patients
Ramic Fort Worth, LLC Past Accepting new patients
Open MRI of Houston Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jschroeder355719@ahs.direct-ci.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1891759676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4320 WESTWAY AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752053728",
            "telephone_number": "214-693-8134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 WESTWAY AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752053728",
            "telephone_number": "214-693-8134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "JAMES",
        "middle_name": "GARY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "J4503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047354801",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132136605",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.