Individual provider Active NPI

Justin Tolentino

  • Internal Medicine Physician
  • Dallas, TX
National Provider Identifier
1013349414
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
R2241 Issued in TX
Practice address
3600 Gaston Ave Ste 550
Dallas, TX 75246-1905
Phone
(214) 821-1177
NPI assigned
Aug 7, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS018094 PA
Internal Medicine Physician 207R00000X R2241 TX Primary

Addresses

Primary practice location

3600 Gaston Ave Ste 550
Dallas, TX 75246-1905

Mailing address

3600 Gaston Ave Ste 550
Dallas, TX 75246-1905
Phone (214) 821-1177

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jtolentino299338@direct.sw.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170822000303 TX Practitioner - Internal Medicine 0345518114 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Mid West Medical College, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

3500 Gaston Ave
FL 1
Dallas, TX 75246-2017
Phone (972) 817-6100

4001 Worth St
Dallas, TX 75246-1608

Hospital & facility affiliations

  • Baylor University Medical Center Hospital, Dallas, TX, CCN 450021
  • The Queens Medical Center Hospital, Honolulu, HI, CCN 120001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS018094PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network Internal Medicine CurrentSince Nov 1, 2018 Accepting new patients
Healthtexas Provider Network CurrentSince Nov 1, 2018 Accepting new patients
Baylor University Medical Center Past Accepting new patients

Locations

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

3600 Gaston Ave
Ste 550
Dallas, TX 75246
Phone (214) 821-1177

3600 Gaston Ave
Ste 558
Dallas, TX 75246

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

700 Walter Reed Blvd
Ste 203
Garland, TX 75042
Phone (972) 426-9900

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1375833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1013349414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 GASTON AVE STE 550",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461905",
            "telephone_number": "214-821-1177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 GASTON AVE STE 550",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461905",
            "telephone_number": "214-821-1177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLENTINO",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-07",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS018094",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "R2241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jtolentino299338@direct.sw.org",
            "affiliation": "N",
            "address_1": "3600 Gaston Ave Ste 550",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752461905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.