ETHAN BOOTHE MD
NPI 1508209495
Radiology - Diagnostic Radiology in Fort Worth, TX
About Ethan Boothe Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ETHAN BOOTHE MD (NPI 1508209495) is an individual diagnostic radiology provider in Fort Worth, Texas, licensed in Texas (Q2741) and active in the NPI registry since April 2013. He is enrolled in Medicare PECOS, is affiliated with Christus Good Shepherd Medical Center, and is a graduate of Louisiana State University School Of Medicine In Shreveport (2013).
NPPES Registry Identity
Specialties & Licenses
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
Ethan Boothe Md 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 Reassignments
5Medicare enrollment records show Ethan Boothe reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Fort Worth, TX 76104
- Reassigned Medicare billing, Texas enrollment
- 5,299 clinicians in this Medicare group
Fort Worth, TX 76107
- Reassigned Medicare billing, Texas, Arkansas, New Mexico and Oklahoma enrollments
- Also billed through NPI 1710970975 (Oklahoma)
- 445 clinicians in this Medicare group
Beaumont, TX 77702
- Reassigned Medicare billing, Texas enrollment
- 57 clinicians in this Medicare group
Lake Charles, LA 70611
- Reassigned Medicare billing, Louisiana enrollment
- 4,559 clinicians in this Medicare group
Mccomb, MS 39648
- Reassigned Medicare billing, Mississippi enrollment
- 326 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.
Areas of Expertise CMS Part B claims 42
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.
Hospital Affiliations CMS Care Compare 5
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Christus Good Shepherd Medical Center
Acute Care Hospitals · Longview, TXJps Health Network
Acute Care Hospitals · Fort Worth, TXBaylor Scott & White Medical Center Hillcrest
Acute Care Hospitals · Waco, TXChristus Mother Frances Hospital
Acute Care Hospitals · Tyler, TXChristus St Michael Health System
Acute Care Hospitals · Texarkana, TXPhysician 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.
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.
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
FORT WORTH, TX 76104
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 Ethan Boothe's NPI number?
The NPI number for Ethan Boothe is 1508209495. It was assigned to this individual provider in the NPPES registry on April 10, 2013.
Where is Ethan Boothe located?
Ethan Boothe practices at 815 Pennsylvania Ave, Fort Worth, TX 76104. The listed phone number is (817) 321-0404.
What is Ethan Boothe's specialty?
The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.
Is Ethan Boothe enrolled in Medicare?
Yes. Ethan Boothe 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 organizations bill Medicare for Ethan Boothe's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Ethan Boothe reassigns Medicare benefits to 5 organizations: University Of Texas Southwestern Medical Center At Dallas (Fort Worth, TX), Radiology Associates Of North Texas, PA (Fort Worth, TX), Crawford Andrews & Davis Ptr (Beaumont, TX), Ochsner Clinic LLC (Lake Charles, LA) and Ochsner Mississippi, LLC (Mccomb, MS). Each 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 Ethan Boothe's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Ethan Boothe 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 3 other insurers list Ethan Boothe 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 Ethan Boothe affiliated with any hospitals?
According to CMS data, Ethan Boothe is affiliated with Christus Good Shepherd Medical Center, Jps Health Network, Baylor Scott & White Medical Center Hillcrest, Christus Mother Frances Hospital and Christus St Michael Health System.
When was this NPI record last updated?
The NPPES record for Ethan Boothe was last updated on July 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.