Organization Active NPI

Rufino G. Talatala, M.D., P.a.

  • Internal Medicine Physician
  • Carrollton, TX
National Provider Identifier
1053596460
Registry record updated Sep 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
K8509 Issued in TX
Legal business name
RUFINO G. TALATALA, M.D., P.A.
Practice address
4221 Medical Pkwy
BLDG 200, Suite 250
Carrollton, TX 75010
Phone
(972) 492-0333
Fax
(972) 394-6585
NPI assigned
Jan 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2016

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

Authorized official

Name
Dr. Rufino Gerona Talatala, M.D.NPI 1093824153
Title
President
Phone
(972) 492-0333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X K8509 TX Primary

Addresses

Primary practice location

4221 Medical Pkwy
BLDG 200, Suite 250
Carrollton, TX 75010

Mailing address

4221 Medical Pkwy
BLDG 200, Suite 250
Carrollton, TX 75010
Phone (972) 492-0333

Other identifiers 1

IdentifierTypeStateIssuer
008HDOtherTXBC/BS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101112000880 TX Part B Supplier - Clinic/Group Practice 6800081068 Receives reassigned benefits from 1 practitioner
Practice locations: Carrollton, TX

National Provider Directory

National Provider Directory

Locations

2245 Marsh Ln
Carrollton, TX 75006
Phone (847) 989-0123

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474070400000",
    "number": "1053596460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4221 MEDICAL PKWY",
            "address_2": "BLDG 200, SUITE 250",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "75010",
            "telephone_number": "972-492-0333",
            "fax_number": "972-394-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4221 MEDICAL PKWY",
            "address_2": "BLDG 200, SUITE 250",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "75010",
            "telephone_number": "972-492-0333",
            "fax_number": "972-394-6585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUFINO G. TALATALA, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-03",
        "last_updated": "2016-09-17",
        "status": "A",
        "authorized_official_last_name": "TALATALA",
        "authorized_official_first_name": "RUFINO",
        "authorized_official_middle_name": "GERONA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-492-0333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K8509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "008HD",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2016; 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.