NPIMap

Organization Active NPI

Central Park Ear Nose and Throat LLP

  • Otolaryngology Physician
  • Arlington, TX
National Provider Identifier
1033264635
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
CENTRAL PARK EAR NOSE AND THROAT LLP
Practice address
409 Central Park Dr
Arlington, TX 76014-2069
Phone
(817) 261-9191
Fax
(817) 784-8301
NPI assigned
Jan 24, 2007
Last updated
Aug 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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

Authorized official

Name
Mr. Stephen E Blake, CPA
Title
Chief Executive Officer
Phone
(817) 261-9191

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

409 Central Park Dr
Arlington, TX 76014-2069

Mailing address

409 Central Park Dr
Arlington, TX 76014-2069
Phone (817) 261-9191

Other practice location 1

2210 San Jacinto Blvd Ste 2
Denton, TX 76205-7531
Phone (817) 261-9191

Other practice location 2

1005 York Dr
DeSoto, TX 75115-2083
Phone (817) 261-9191

Other practice location 3

3324 Colorado Blvd Ste 103
Denton, TX 76210-6891
Phone (940) 891-1788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070228000635 TX Part B Supplier - Clinic/Group Practice 3476655077 Receives reassigned benefits from 15 practitioners
2 other NPIs on this enrollment
Practice locations: Arlington, TX; Fort Worth, TX

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690934400000",
    "number": "1033264635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 CENTRAL PARK DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760142069",
            "telephone_number": "817-261-9191",
            "fax_number": "817-784-8301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 CENTRAL PARK DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760142069",
            "telephone_number": "817-261-9191",
            "fax_number": "817-784-8301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2210 San Jacinto Blvd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Denton",
            "state": "TX",
            "postal_code": "762057531",
            "country_code": "US",
            "telephone_number": "817-261-9191",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1005 York Dr",
            "address_purpose": "LOCATION",
            "city": "DeSoto",
            "state": "TX",
            "postal_code": "751152083",
            "country_code": "US",
            "telephone_number": "817-261-9191",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3324 Colorado Blvd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Denton",
            "state": "TX",
            "postal_code": "762106891",
            "country_code": "US",
            "telephone_number": "940-891-1788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTRAL PARK EAR NOSE AND THROAT LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A",
        "authorized_official_last_name": "BLAKE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "817-261-9191",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.