Ethan Tang, MD in Fort Worth, TX

Ethan Tang, MD is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Fort Worth, Texas. 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 Tang is licensed to practice in Texas (license number V7079) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1366948721.

Contact Information

	Ethan Tang, MD
	815 Pennsylvania Ave, Fort Worth, TX 76104-2294
	(817) 321-0404
	Not Available

Map and Direction

Physician's Profile

Full Name	Ethan Tang
Gender	Male
Speciality	Radiology - Diagnostic Radiology
Location	815 Pennsylvania Ave, Fort Worth, Texas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1366948721
Provider Enumeration Date: 04/04/2018
Last Update Date: 05/21/2025

Medicare PECOS Information:

PECOS PAC ID: 3072055508
Enrollment ID: I20240611004260

Medical Identifiers

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

Identifier	Type	State	Issuer
1366948721	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2085R0202X	Radiology - Diagnostic Radiology	58735 (Arizona)	Secondary
2085R0202X	Radiology - Diagnostic Radiology	V7079 (Texas)	Primary

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 Tang allows following entities to bill medicare on his behalf.

Entity Name	Sjhmc Physician Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1326098005 PECOS PAC ID: 4486646197 Enrollment ID: O20040401001189

Entity Name	Smi Imaging Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1972004489 PECOS PAC ID: 3476696220 Enrollment ID: O20180829003142

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 Tang 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 Tang, MD 1320 S University Dr Ste 500, Fort Worth, TX 76107-5732 Ph: (817) 321-0404	Ethan Tang, MD 815 Pennsylvania Ave, Fort Worth, TX 76104-2294 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: Medicare Enrolled Practice Location: 815 Pennsylvania Ave, Fort Worth, TX 76104 Phone: 173-210-4048
Dr. John A Queralt, MD Radiology Medicare: Accepting 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: Accepting 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: Accepting Medicare Assignments Practice Location: 815 Pennsylvania Ave, Fort Worth, TX 76104 Phone: 817-321-0404
Dr. Jeffrey Scott Wenzel, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 815 Pennsylvania Ave, Fort Worth, TX 76104 Phone: 817-321-0387
Dr. Robert Lewis Emery, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 815 Pennsylvania Ave, Fort Worth, TX 76104 Phone: 817-321-0404

Ethan Tang, MD - Medicare Radiology in Fort Worth, TX