Individual provider Active NPI

Richard Lee Smith, PA-C

  • Physician Assistant
  • Fort Worth, TX
National Provider Identifier
1912088147
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA03242 Issued in TX
Practice address
4444 Heritage Trace Pkwy Ste 408
Fort Worth, TX 76244-8944
Phone
(817) 283-5252
Fax
(817) 283-5283
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Surgical Physician Assistant 363AS0400X PA03242 TX
Physician Assistant 363A00000X PA03242 TX Primary

Addresses

Primary practice location

4444 Heritage Trace Pkwy Ste 408
Fort Worth, TX 76244-8944

Mailing address

4444 Heritag Trce Pkwy Ste 408
Fort Worth, TX 76244-8944
Phone (817) 283-5252

Other practice location 1

809 W Harwood Rd
Suite 101
Hurst, TX 76054-3289
Phone (817) 283-5252

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060303000684 TX Practitioner - Physician Assistant 3476569138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lone Star Orthopaedic and Spine Specialists, PLLCGroup PAC ID 5597844951, 19 clinicians

Practice addresses (Care Compare)

167 Regency Pkwy
Suite 103
Mansfield, TX 76063-5093
Phone (682) 341-7110

Hospital & facility affiliations

  • Texas Health Huguley Hospital Fort Worth South Hospital, Fort Worth, TX, CCN 450677

Merit-based Incentive Payment System (MIPS)

Final score
83.21 of 100Reported as group
Quality
83.88
Promoting interoperability
98
Improvement activities
40
Cost
57.86

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA03242TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lone Star Orthopaedic and Spine Specialists, PLLC CurrentSince Jul 6, 2023 Accepting new patients
Lone Star Orthopaedic and Spine Specialists, PLLC CurrentSince Jul 6, 2023 Accepting new patients
Tyler Neurosurgical Associates, P.a. Past Accepting new patients
Fort Worth Brain & Spine Institute, LLP Past Accepting new patients
Physicians and Allied Health Professionals Group, PA Past Accepting new patients

Locations

215 Old Highway 1187
Burleson, TX 76028
Phone 8179262663118

167 Regency Pkwy
Ste 103
Mansfield, TX 76063
Phone (682) 341-7110

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EABGAA

Organizations & group practices 5

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1912088147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4444 HERITAG TRCE PKWY STE 408",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762448944",
            "telephone_number": "817-283-5252",
            "fax_number": "817-283-5283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 HERITAGE TRACE PKWY STE 408",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762448944",
            "telephone_number": "817-283-5252",
            "fax_number": "817-283-5283"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "809 W Harwood Rd",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Hurst",
            "state": "TX",
            "postal_code": "760543289",
            "country_code": "US",
            "telephone_number": "817-283-5252",
            "fax_number": "817-283-5283",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RICHARD",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA03242",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.