Ethan Boothe, MD in Fort Worth, TX - Medicare Diagnostic Radiology

Ethan Boothe, MD is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Fort Worth, Texas. He went to Louisiana State University School Of Medicine In Shreveport and graduated in 2013 and has 12 years of diverse experience with area of expertise as Diagnostic Radiology. He is a member of the group practice Crawford Andrews And Davis Ptr, Radiology Associates Of North Texas Pa, Radiology Associates Of North Texas Pa, Ochsner Clinic Llc and his current practice location is 815 Pennsylvania Ave, Fort Worth, Texas. You can reach out to his office (for appointments etc.) via phone at (817) 321-0404.

Ethan Boothe is licensed to practice in Texas (license number Q2741) and he also participates in the medicare program. He may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1508209495.

Contact Information

	Ethan Boothe, MD
	815 Pennsylvania Ave, Fort Worth, TX 76104-2224
	(817) 321-0404
	Not Available

Map and Direction

Physician's Profile

Full Name	Ethan Boothe
Gender	Male
Speciality	Diagnostic Radiology
Experience	12 Years
Location	815 Pennsylvania Ave, Fort Worth, Texas
Accepts Medicare Assignments	May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance.

Medical Education and Training:

Ethan Boothe attended and graduated from Louisiana State University School Of Medicine In Shreveport in 2013

NPI Data:

NPI Number: 1508209495
Provider Enumeration Date: 04/10/2013
Last Update Date: 07/30/2025

Medicare PECOS Information:

PECOS PAC ID: 9234488602
Enrollment ID: I20180817000850

Medical Identifiers

Medical identifiers for Ethan Boothe such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1508209495	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2085R0202X	Radiology - Diagnostic Radiology	Q2741 (Texas)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Jps Health Network	Fort worth, TX	Hospital
Christus St Michael Health System	Texarkana, TX	Hospital
Christus Mother Frances Hospital	Tyler, TX	Hospital
Texas Health Harris Methodist Hospital Fort Worth	Fort worth, TX	Hospital
Northwest Texas Hospital	Amarillo, TX	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Crawford Andrews And Davis Ptr	6507814084	39
Radiology Associates Of North Texas Pa	7911897301	325
Radiology Associates Of North Texas Pa	7911897301	325
Ochsner Clinic Llc	8224933619	2538

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ethan Boothe allows following entities to bill medicare on his behalf.

Entity Name	University Of Texas Southwestern Medical Center At Dallas
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1942270566 PECOS PAC ID: 0648188250 Enrollment ID: O20031106000792

Entity Name	Radiology Associates Of North Texas Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1053470179 PECOS PAC ID: 7911897301 Enrollment ID: O20040617000531

Entity Name	Crawford Andrews & Davis Ptr
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1952325573 PECOS PAC ID: 6507814084 Enrollment ID: O20050111000836

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ethan Boothe is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Ethan Boothe, MD 816 W Cannon St, Fort Worth, TX 76104-3146 Ph: (173) 210-9378	Ethan Boothe, MD 815 Pennsylvania Ave, Fort Worth, TX 76104-2224 Ph: (817) 321-0404

Reviews and Comments

Radiology Doctors in Fort Worth, TX

Kelly C Starkey, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 815 Pennsylvania Ave, Fort Worth, TX 76104 Phone: 817-321-0404 Fax: 469-522-6889
Dr. Mark Sohner, M.D. Radiology Medicare: May Accept Medicare Assignments Practice Location: 815 Pennsylvania Ave, Fort Worth, TX 76104 Phone: 173-210-4048
Dr. John A Queralt, MD Radiology Medicare: May Accept Medicare Assignments Practice Location: 815 Pennsylvania Ave, Fort Worth, TX 76104 Phone: 817-321-0312 Fax: 817-317-7033
Dr. Robert Joseph Reeb Jr., MD Radiology Medicare: May Accept Medicare Assignments Practice Location: 815 Pennsylvania Ave, Fort Worth, TX 76104 Phone: 817-321-0312 Fax: 817-317-7033
Eugenia Payne, M.D Radiology Medicare: Medicare Enrolled Practice Location: 815 Pennsylvania Ave, Fort Worth, TX 76104 Phone: 817-321-0404
Dr. Jeffrey Scott Wenzel, M.D. Radiology Medicare: May Accept Medicare Assignments Practice Location: 815 Pennsylvania Ave, Fort Worth, TX 76104 Phone: 817-321-0387
Dr. Robert Lewis Emery, M.D. Radiology Medicare: May Accept Medicare Assignments Practice Location: 815 Pennsylvania Ave, Fort Worth, TX 76104 Phone: 817-321-0404

Ethan Boothe, MD - Medicare Diagnostic Radiology in Fort Worth, TX