Individual provider Active NPI

Richard Hartin Jr., MD

  • Family Medicine Physician
  • La Grange, TX
National Provider Identifier
1023070687
Registry record updated Jul 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G6524 Issued in TX
Practice address
One St. Mark'S Place
St. Mark'S Hospital
La Grange, TX 78945-1250
Phone
(979) 242-2333
Fax
(979) 242-5171
NPI assigned
Apr 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G6524 TX
Family Medicine Physician 207Q00000X G6524 TX Primary

Addresses

Primary practice location

One St. Mark'S Place
St. Mark'S Hospital
La Grange, TX 78945-1250

Mailing address

2777 Owl Creek Rd
La Grange, TX 78945-5449
Phone (512) 569-8993

Other identifiers 2

IdentifierTypeStateIssuer
134102612MedicaidTX
P00375536OtherTXRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050922000107 TX Practitioner - Emergency MedicinePractitioner - Family Practice 4183658875 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246492800000",
    "number": "1023070687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2777 OWL CREEK RD",
            "city": "LA GRANGE",
            "state": "TX",
            "postal_code": "789455449",
            "telephone_number": "512-569-8993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE ST. MARK'S PLACE",
            "address_2": "ST. MARK'S HOSPITAL",
            "city": "LA GRANGE",
            "state": "TX",
            "postal_code": "789451250",
            "telephone_number": "979-242-2333",
            "fax_number": "979-242-5171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTIN",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2009-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "G6524",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "G6524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134102612",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00375536",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grange, TX

Sources for this page

Verify at the official NPI Registry.