Individual provider Active NPI

David Edward Parkus, M.D

  • Trauma Surgery Physician
  • Beaumont, TX
National Provider Identifier
1023017613
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
K4519 Issued in TX
Practice address
2965 Harrison St Ste 211
Beaumont, TX 77702-1149
Phone
(409) 899-8501
Fax
(409) 899-8510
NPI assigned
Jul 18, 2005
Last updated
Sep 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X K4519 TX
Trauma Surgery Physician 2086S0127X K415 TX
Trauma Surgery Physician 2086S0127X K4519 TX Primary

Addresses

Primary practice location

2965 Harrison St Ste 211
Beaumont, TX 77702-1149

Mailing address

PO Box 12909
Beaumont, TX 77726-2909
Phone (409) 899-8501

Other identifiers 2

IdentifierTypeStateIssuer
PO88840JOMedicaidTX
835M1MedicaidTX

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
I20110321000829 TX Practitioner - General SurgeryPractitioner - Emergency Medicine 9931244589 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Emergency Medicine
Education
Emory University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Surgical Critical Care Associates, LLPGroup PAC ID 3274532494, 4 clinicians

Practice addresses (Care Compare)

2965 Harrison Ave
Suite 211
Beaumont, TX 77702-1149

2965 Harrison St
Suite 211
Beaumont, TX 77702-1149
Phone (409) 899-8501

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K4519TXMDSurgery Physician
K415TXMDTrauma Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Surgical Critical Care Associates, LLP Surgery CurrentSince Jul 1, 2000 Accepting new patients
Christus Health Southeast Texas Past Accepting new patients
C H Wilkinson Physician Network PastSince Sep 25, 2022 Accepting new patients

Locations

2965 Harrison Ave
Ste 211
Beaumont, TX 77702
Phone (409) 899-7863

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1023017613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12909",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777262909",
            "telephone_number": "409-899-8501",
            "fax_number": "409-899-8510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2965 HARRISON ST STE 211",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021149",
            "telephone_number": "409-899-8501",
            "fax_number": "409-899-8510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKUS",
        "first_name": "DAVID",
        "middle_name": "EDWARD",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "K4519",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "TX",
            "license": "K415",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "TX",
            "license": "K4519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PO88840JO",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "835M1",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.