Organization Active NPI

Robert J. Rogers, M.D., P.a.

  • Medical Specialty Clinic/Center
  • Fort Worth, TX
National Provider Identifier
1912169467
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
F4444 Issued in TX
Legal business name
ROBERT J. ROGERS, M.D., P.A.
Practice address
4200 S Hulen St Ste 230
Fort Worth, TX 76109-4924
Phone
(818) 315-2550
Fax
(817) 732-4660
NPI assigned
Jun 26, 2008
Last updated
Mar 31, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Authorized official

Name
Dr. Robert J. Rogers, M.D.NPI 1619970969
Title
Director
Phone
(817) 315-2550

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
Medical Specialty Clinic/Center 261QM2500X F4444 TX Primary

Addresses

Primary practice location

4200 S Hulen St Ste 230
Fort Worth, TX 76109-4924

Mailing address

4200 S Hulen St Ste 230
Fort Worth, TX 76109-4924
Phone (818) 315-2550

Other identifiers 1

IdentifierTypeStateIssuer
033448401MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081021000876 TX Part B Supplier - Clinic/Group Practice 4789742677 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Worth, TX

National Provider Directory

National Provider Directory

Locations

5929 Lovell Ave
Ft Worth, TX 76107
Phone (817) 315-2550

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648684800000",
    "number": "1912169467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 S HULEN ST STE 230",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094924",
            "telephone_number": "818-315-2550",
            "fax_number": "817-732-4660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 S HULEN ST STE 230",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094924",
            "telephone_number": "818-315-2550",
            "fax_number": "817-732-4660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT J. ROGERS, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-26",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "817-315-2550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "TX",
            "license": "F4444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "033448401",
            "state": "TX"
        }
    ],
    "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 Mar 31, 2022; 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.