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FORT WORTH DIAGNOSTIC CLINIC PA
NPI 1669665774
Specialist in Fort Worth, TX

Active since August 22, 2007
1650 W ROSEDALE ST STE 100, FORT WORTH, TX 76104(817) 338-1131(817) 877-1511 Get Directions Write a Review

NPPES record last updated: March 17, 2015. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Fort Worth Diagnostic Clinic Pa NPPES

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

FORT WORTH DIAGNOSTIC CLINIC PA (NPI 1669665774) is a healthcare organization registered as a specialist in Fort Worth, Texas and active in the NPI registry since August 2007. The organization lists Paul Jay Goldman, Physician, as its authorized official.

NPPES Registry Identity

NPI1669665774
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameFORT WORTH DIAGNOSTIC CLINIC PA
Location Address1650 W ROSEDALE ST STE 100Fort Worth, TX 76104-7400
Mailing Address1650 W Rosedale St Ste 100Fort Worth, TX 76104-7400 · (817) 338-1131 · Fax (817) 877-1511
Phone(817) 338-1131
Fax(817) 877-1511
Organization SubpartNo
Authorized OfficialPaul Jay GoldmanPhysician · (817) 338-1131
Enumeration DateAugust 22, 2007
Last NPPES UpdateMarch 17, 2015
✔ NPI 1669665774 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in TX · E8262
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
1650 W ROSEDALE ST STE 100, Fort Worth, TX 76104
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Other Identifiers 3

Medicare PIN87T873TX
Medicare UPINC16203TX
Medicaid083588601TX

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Fort Worth Diagnostic Clinic Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Fort Worth Diagnostic Clinic PA, which bills Medicare for the services this clinician delivers.

Clinician (1)

Paul Goldman, M.D.
Internal Medicine
NPI 1053430975
1650 W ROSEDALE ST STE 100
Fort Worth, TX 76104
(817) 338-1131
✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Fort Worth Diagnostic Clinic PA's NPI number?

The NPI number for Fort Worth Diagnostic Clinic PA is 1669665774. It was assigned to this organization in the NPPES registry on August 22, 2007.

Where is Fort Worth Diagnostic Clinic PA located?

Fort Worth Diagnostic Clinic PA is located at 1650 W Rosedale St Ste 100, Fort Worth, TX 76104. The listed phone number is (817) 338-1131.

What is Fort Worth Diagnostic Clinic PA's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Fort Worth Diagnostic Clinic PA enrolled in Medicare?

Yes. Fort Worth Diagnostic Clinic PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Fort Worth Diagnostic Clinic PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Fort Worth Diagnostic Clinic PA. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Fort Worth Diagnostic Clinic PA was last updated on March 17, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.