NPIMap

Individual provider Active NPI

Thomas W Ertzner, MD

  • Diagnostic Radiology Physician
  • Corpus Christi, TX
National Provider Identifier
1013902071
Registry record updated Dec 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
H3031 Issued in TX
Practice address
3226 S Alameda St
Corpus Christi, TX 78404-2508
Phone
(361) 888-6684
Fax
(361) 888-6686
NPI assigned
Sep 15, 2005
Last updated
Dec 9, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X H3031 TX Primary

Addresses

Primary practice location

3226 S Alameda St
Corpus Christi, TX 78404-2508

Mailing address

3226 Reid Dr
Corpus Christi, TX 78404-2552
Phone (361) 853-4503

Other identifiers 1

IdentifierTypeStateIssuer
118302201MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20031223000610 TX Practitioner - Diagnostic Radiology 3678471950 Reassigns benefits to 1 organization
I20170816000691 CO Practitioner - Diagnostic RadiologyPractitioner - Nuclear Medicine 3678471950 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Nuclear Medicine
Education
University of Nebraska College of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Singleton Associates PAGroup PAC ID 6305731118, 814 clinicians

Practice addresses (Care Compare)

2808 N Lafayette St
Denver, CO 80205-4451
Phone (832) 355-4112

2912 Cathedral Park VW
Colorado Springs, CO 80904-4722
Phone (832) 355-4122

3315 S Alameda St
Corpus Christi Medical Center Doctors Regio
Corpus Christi, TX 78411-1820
Phone (361) 761-1000

539 Lions Ridge Rd
Carbondale, CO 81623-8805
Phone (832) 355-4112

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H3031TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Singleton Associates PA Diagnostic Radiology CurrentSince Jul 1, 2022 Accepting new patients
Memorial MRI and Diagnostic LLC Diagnostic Radiology CurrentSince Jan 2, 2018 Accepting new patients
Cardiovascular Care Providers, Inc. Past Accepting new patients

Locations

1241 Campbell Rd
Houston, TX 77055
Phone (713) 568-6095

1346 Campbell Rd
Houston, TX 77055

6720 Bertner Ave
#2270
Houston, TX 77030
Phone (832) 355-4092

Organizations & group practices 5

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

Hospital & facility affiliations 5

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": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323388800000",
    "number": "1013902071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3226 REID DR",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784042552",
            "telephone_number": "361-853-4503",
            "fax_number": "361-853-4454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3226 S ALAMEDA ST",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784042508",
            "telephone_number": "361-888-6684",
            "fax_number": "361-888-6686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERTZNER",
        "first_name": "THOMAS",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2011-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "H3031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118302201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.