KEITH PETTIBON MD
NPI 1467744573
Radiology - Diagnostic Radiology in Fort Worth, TX

Active since May 07, 2011PECOS Enrolled
93.65/100
CMS Quality Rating
815 PENNSYLVANIA AVE, FORT WORTH, TX 76104(817) 321-0404 Get Directions Write a Review

NPPES record last updated: June 13, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 13, 2024, Nov 6, 2018, Jun 22, 2018 and 1 more (4 updates tracked since 2016).

About Keith Pettibon Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEITH PETTIBON MD (NPI 1467744573) is an individual diagnostic radiology provider in Fort Worth, Texas, licensed in Texas (R1614) and active in the NPI registry since May 2011. He is enrolled in Medicare PECOS, is affiliated with Texas Health Harris Methodist Hospital Fort Worth, and is a graduate of Other (2011).

NPPES Registry Identity

NPI1467744573
Entity TypeIndividualMale
Primary Taxonomy2085R0202X
Provider Legal NameKEITH PETTIBONCredential: MD
Location Address815 PENNSYLVANIA AVEFort Worth, TX 76104
Mailing Address816 W Cannon StFort Worth, TX 76104-3146 · (817) 321-0404
Sole ProprietorYes
Medical School CMSOtherGraduated 2011
Enumeration DateMay 7, 2011
Last NPPES UpdateJune 13, 20244 updates tracked since enumeration
NPPES CertifiedJune 13, 2024
NPI 1467744573 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
License Licensed in TX · R1614
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Also ListedRadiology · Vascular & Interventional RadiologyTaxonomy 2085R0204X · License R1614 (TX)
815 PENNSYLVANIA AVE, Fort Worth, TX 76104

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Keith Pettibon Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3870739691
PECOS Enrollment IDI20170328002046, I20250822004117
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 54

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

X-ray of chest, 1 view 71045
A chest X-ray, 1 view, is a quick, painless test that produces images of the structures within your chest, such as your heart, lungs, and blood vessels. It helps in diagnosing conditions like pneumonia, heart problems, or lung cancer. You'll stand in front of a machine that emits X-rays, which pass through your body to create the image.
1,240 services1,128 patients
Ct scan head or brain without contrast 70450
A CT scan of the head or brain without contrast is a non-invasive imaging procedure. It uses X-rays to create detailed pictures of your brain, skull, and other structures inside your head. It helps to detect conditions like strokes, tumors, or injuries. No dye (contrast) is used in this test.
552 services548 patients
Ct scan of abdomen and pelvis with contrast 74177
A CT scan of the abdomen and pelvis with contrast is an imaging procedure. A special dye, called contrast, is used to make certain areas more visible. This can help identify issues such as infections, tumors, or other abnormalities. The procedure is painless and usually takes about 30 minutes.
339 services336 patients
Ct scan of abdomen and pelvis without contrast 74176
A CT scan of the abdomen and pelvis is a non-invasive medical test. It uses special X-ray equipment to create detailed images of your abdominal and pelvic areas. This helps doctors examine organs, tissues, and vessels. No contrast dye is used in this procedure.
231 services230 patients
Ct scan of upper spine without contrast 72125
A CT scan of the upper spine without contrast is a non-invasive imaging test that uses X-rays to capture detailed images of your neck and upper back. It helps in identifying issues like fractures, tumors, or infections. No dye (contrast) is used in this scan.
223 services222 patients
Ct scan of blood vessels of chest with contrast 71275
A CT scan of the chest with contrast is a non-invasive imaging test. It uses X-rays and a special dye to get detailed images of your blood vessels in the chest. This helps in diagnosing conditions related to heart and lungs.
213 services213 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Texas Health Harris Methodist Hospital Fort Worth

Acute Care Hospitals · Fort Worth, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number450135
Location1301 Pennsylvania AvenueFort Worth, TX 76104 · Tarrant County
Emergency services Birthing friendly

Baylor Scott & White All Saints Medical Center Fort Worth

Acute Care Hospitals · Fort Worth, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450137
Location1400 Eighth AveFort Worth, TX 76104 · Tarrant County
Birthing friendly

Baylor Scott & White Medical Center Grapevine

Acute Care Hospitals · Grapevine, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450563
Location1650 W College StGrapevine, TX 76051 · Tarrant County
Emergency services Birthing friendly

Medical City Fort Worth

Acute Care Hospitals · Fort Worth, TX
2/5 CMS rating
OwnershipProprietary
CMS Certification Number450672
Location900 Eighth AvenueFort Worth, TX 76104 · Tarrant County
Emergency services

Texas Health Harris Methodist Hospital Southwest F

Acute Care Hospitals · Fort Worth, TX
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450779
Location6100 Harris PkwyFort Worth, TX 76132 · Tarrant County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$87.20 typical visit price
range $56.47 – $171.07
Typical copayment $21.80 (range $14.11 – $42.76)
Most-billed visit code 99203
Established Patient
$70.45 typical visit price
range $18.18 – $139.68
Typical copayment $17.61 (range $4.54 – $34.92)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

93.65/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality92.53
Improvement Activities40

Reported Quality Measures

Prevention of Central Venous Catheter (CVC) - Related Bloodstream Infections
Percentage of patients, regardless of age, who undergo central venous catheter (CVC) insertion for whom CVC was inserted with all elements of maximal sterile barrier technique, hand hygiene, skin preparation and, if ultrasound is used, sterile ultrasound…
95%76 patients
Radiation Consideration for Adult CT: Utilization of Dose Lowering Techniques
Percentage of final reports for patients aged 18 years and older undergoing CT with documentation that one or more of the following dose reduction techniques were used: - Automated exposure control - Adjustment of the mA and/or kV according to patient size -…
100%697 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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.

Radiology (Diagnostic Radiology)
815 PENNSYLVANIA AVE
FORT WORTH, TX 76104
Radiology (Diagnostic Radiology)
815 PENNSYLVANIA AVE
FORT WORTH, TX 76104
Radiology (Diagnostic Radiology)
815 PENNSYLVANIA AVE
FORT WORTH, TX 76104
Radiology (Diagnostic Radiology)
815 PENNSYLVANIA AVE
FORT WORTH, TX 76104
Radiology (Diagnostic Radiology)
815 PENNSYLVANIA AVE
FORT WORTH, TX 76104
Radiology (Diagnostic Radiology)
815 PENNSYLVANIA AVE
FORT WORTH, TX 76104
Radiology (Diagnostic Radiology)
815 PENNSYLVANIA AVE
FORT WORTH, TX 76104
Radiology (Diagnostic Radiology)
815 PENNSYLVANIA AVE
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 Keith Pettibon's NPI number?

The NPI number for Keith Pettibon is 1467744573. It was assigned to this individual provider in the NPPES registry on May 7, 2011.

Where is Keith Pettibon located?

Keith Pettibon practices at 815 Pennsylvania Ave, Fort Worth, TX 76104. The listed phone number is (817) 321-0404.

What is Keith Pettibon's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Is Keith Pettibon enrolled in Medicare?

Yes. Keith Pettibon is registered in the Medicare PECOS enrollment system.

What insurance does Keith Pettibon accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 4 other insurers list Keith Pettibon 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.

Is Keith Pettibon affiliated with any hospitals?

According to CMS data, Keith Pettibon is affiliated with Texas Health Harris Methodist Hospital Fort Worth, Baylor Scott & White All Saints Medical Center Fort Worth, Baylor Scott & White Medical Center Grapevine, Medical City Fort Worth and Texas Health Harris Methodist Hospital Southwest F.

When was this NPI record last updated?

The NPPES record for Keith Pettibon was last updated on June 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.