DR. SAMUEL THOMAS SELBY D.O.
NPI 1114283652
Pediatrics - Pediatric Emergency Medicine in Fort Worth, TX
About Dr. Samuel Thomas Selby D.o. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. SAMUEL THOMAS SELBY D.O. (NPI 1114283652) is an individual pediatric emergency medicine provider in Fort Worth, Texas, licensed in Texas (R6899) and active in the NPI registry since April 2012. He is enrolled in Medicare PECOS and is a graduate of Other (2012).
NPPES Registry Identity
Specialties & Licenses 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Samuel Thomas Selby D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Samuel Selby reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Fort Worth, TX 76104
- Reassigned Medicare billing, Texas enrollment
- Medicare enrollment name: Cook Childrens Physician Network
- 1,186 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FORT WORTH, TX 76104
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Samuel Selby's NPI number?
The NPI number for Samuel Selby is 1114283652. It was assigned to this individual provider in the NPPES registry on April 10, 2012.
Where is Samuel Selby located?
Samuel Selby practices at 801 7th Ave, Fort Worth, TX 76104. The listed phone number is (682) 885-4095.
What is Samuel Selby's specialty?
The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Emergency Medicine, with taxonomy code 2080P0204X.
Is Samuel Selby enrolled in Medicare?
Yes. Samuel Selby is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Samuel Selby's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Samuel Selby reassigns Medicare benefits to Cook Children's Physician Network (Fort Worth, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Samuel Selby's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Samuel Selby accept?
Health plans from Baylor Scott and White Health Plan and Imperial Insurance Companies, Inc. list Samuel Selby as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Samuel Selby was last updated on April 9, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Samuel Thomas Selby, D.O. · NPI 1114283652
Pediatric Emergency Medicine physician in Fort Worth, Texas. Individual provider, active in the CMS NPPES registry since April 10, 2012.
## Identity
- **NPI:** 1114283652 (Entity type: Individual)
- **Enumerated:** April 10, 2012
- **Primary specialty:** Pediatrics - Pediatric Emergency Medicine · taxonomy 2080P0204X
- **State license:** R6899 (Texas)
- **Sole proprietor:** No
## Practice location
- **Address:** 801 7TH AVE, Fort Worth, TX 76104-2733
- **Phone:** (682) 885-4095
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Cook Children's Physician Network (NPI 1083472062, Fort Worth, TX), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2012
## Record status
- **NPPES last updated:** April 9, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1114283652) · Data from the CMS NPPES public registry.