Doctor profile · Federal record
Dr. Keith Pettibon, MD
Diagnostic Radiology Physician (CMS: Diagnostic Radiology) · Vascular & Interventional Radiology Physician · Fort Worth, TX
- NPI 1467744573
- MIPS 93.7 / 100 · 2023
- 15 yrs in practice
- Male
- Solo practice
- No sanctions
Practice & contact
- Primary practice
-
815 Pennsylvania Ave
Fort Worth, TX 76104
(817) 321-0404 - Mailing address
-
816 W Cannon St
Fort Worth, TX 761043146
Credentials & registration
- NPI registered
- May 2011 — 15 yrs on file
- Profile last updated
- June 13, 2024
- Year of graduation
- 2011 — 15 yrs since
- Specialty taxonomy
- 2085R0202X — NUCC code
- State license (1)
- Texas #R1614
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1467744573. Last verified May 11, 2026.Medicare procedures · 2023
Top services delivered
Total services
3,540
Distinct HCPCS
10
Medicare allowed
$164,470
| HCPCS | Description | Services | Patients | Avg allowed | |
|---|---|---|---|---|---|
71045 |
X-ray of chest, 1 view | 835 | 770 | $9 | |
70450 |
Ct scan head or brain without contrast | 360 | 353 | $39 | |
74177 |
Ct scan of abdomen and pelvis with contrast | 210 | 209 | $87 | |
75774 |
Review by radiologist of additional artery image | 176 | 34 | $46 | |
74176 |
Ct scan of abdomen and pelvis without contrast | 173 | 172 | $82 | |
71275 |
Ct scan of blood vessels of chest with contrast | 169 | 169 | $85 | |
76937 |
Ultrasonic guidance for blood vessel access | 160 | 115 | $14 | |
99152 |
Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes | 116 | 101 | $12 | |
72125 |
Ct scan of upper spine without contrast | 115 | 114 | $46 | |
74018 |
X-ray of abdomen, 1 view | 65 | 62 | $9 |
In context: peer comparison
Among 91 peers in Fort Worth Diagnostic Radiology Physician, average services per provider: 88. This provider delivers 40× the peer median.Open Payments
Industry payments received
All-time total
$1,264
Transactions
53
Manufacturers
9
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Boston Scientific Corporation | 31 | $607.71 | |
| Terumo Medical Corporation | 2 | $200.14 | |
| Inari Medical, INC. | 7 | $153.13 | |
| Balt USA, LLC | 3 | $63.81 | |
| TriSalus Life Sciences, INC. | 2 | $61.47 | |
| ShockWave Medical, INC | 3 | $57.01 | |
| Sirtex Medical INC | 3 | $54.59 | |
| Penumbra, INC. | 1 | $48.28 | |
| Ethicon US, LLC | 1 | $17.87 |
By nature of payment
Hospital affiliations
Frequently asked questions
What is Dr. Keith Pettibon's medical specialty?
Dr. Keith Pettibon practices Diagnostic Radiology Physician in Fort Worth, TX.
Where does Dr. Keith Pettibon practice?
Dr. Keith Pettibon practices at 815 Pennsylvania Ave, Fort Worth, TX 76104. Office phone: 8173210404.
What is Dr. Keith Pettibon's NPI?
Dr. Keith Pettibon's National Provider Identifier (NPI) is 1467744573, issued by NPPES.
Does Dr. Keith Pettibon accept Medicare assignment?
Dr. Keith Pettibon does not accept Medicare assignment for all services. Patients may be billed amounts beyond Medicare-allowed charges.
What procedures does Dr. Keith Pettibon commonly perform?
Top Medicare-reported procedures in 2023: X-ray of chest, 1 view (HCPCS 71045); Ct scan head or brain without contrast (HCPCS 70450); Ct scan of abdomen and pelvis with contrast (HCPCS 74177). Source: CMS Medicare Physician & Other Practitioners file.