NPIMap

Individual provider Active NPI

Carla Anderson, MD

  • Diagnostic Radiology Physician
  • Desoto, TX
National Provider Identifier
1922057959
Registry record updated Mar 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
J8882 Issued in TX
Practice address
1750 North Hampton Road
Desoto, TX 75115
Phone
(214) 946-4397
Fax
(214) 946-4399
NPI assigned
May 8, 2006
Last updated
Mar 28, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2016

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 J8882 TX Primary

Addresses

Primary practice location

1750 North Hampton Road
Desoto, TX 75115

Mailing address

815 Pennsylvania Ave
Fort Worth, TX 76104-2224
Phone (817) 321-0937

Other identifiers 2

IdentifierTypeStateIssuer
35943202MedicaidTX
81R914OtherTXDALLAS COUNTY PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040129000402 TX Practitioner - Diagnostic Radiology 2163325341 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Albert Einstein College of Medicine of Yeshiva University, 1989
Medicare assignment
May accept Medicare assignment
Group practices
Methodist-CdiGroup PAC ID 3072836600, 43 clinicians

Practice addresses (Care Compare)

17980 Dallas Pkwy
Suite 200
Dallas, TX 75287-6817
Phone (817) 321-0937

2975 E Broad St
Suite 101
Mansfield, TX 76063-9147
Phone (214) 420-5445

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist-Cdi Diagnostic Radiology Current Accepting new patients
Methodist-Cdi Diagnostic Radiology CurrentSince Jan 18, 2016 Accepting new patients
Radiology Associates of North Texas PA Diagnostic Radiology CurrentSince Mar 28, 2016 Accepting new patients
Methodist-Cdi Diagnostic Radiology CurrentSince Jan 18, 2016 Accepting new patients

Locations

17980 Dallas Pkwy
Ste 200
Dallas, TX 75287
Phone (972) 248-1303

1750 N Hampton Rd
Desoto, TX 75115
Phone (214) 420-5400

815 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 321-0300

816 W Cannon St
Ft Worth, TX 76104
Phone (817) 321-0312

2975 E Broad St
Ste 101
Mansfield, TX 76063
Phone (214) 420-5445

8080 Independence Pkwy
Ste 105
Plano, TX 75025
Phone (972) 208-1858

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459123200000",
    "number": "1922057959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 PENNSYLVANIA AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042224",
            "telephone_number": "817-321-0937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 NORTH HAMPTON ROAD",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "75115",
            "telephone_number": "214-946-4397",
            "fax_number": "214-946-4399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "CARLA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2016-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "J8882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35943202",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DALLAS COUNTY PTAN",
            "identifier": "81R914",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Desoto, TX

Sources for this page

Verify at the official NPI Registry.