Individual provider Active NPI

Thomas Richard Windisch, M.D.

  • Diagnostic Radiology Physician
  • Lubbock, TX
National Provider Identifier
1073519419
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
J2419 Issued in TX
Practice address
3601 21St St
Lubbock, TX 79410-1229
Phone
(806) 791-0399
Fax
(806) 791-0373
NPI assigned
Jun 21, 2005
Last updated
Jan 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X J2419 TX Primary
Vascular & Interventional Radiology Physician 2085R0204X J2419 TX

Addresses

Primary practice location

3601 21St St
Lubbock, TX 79410-1229

Mailing address

2215 Nashville Ave
Lubbock, TX 79410-1105
Phone (806) 725-5844

Other identifiers 6

IdentifierTypeStateIssuer
1146374OtherFIRST HEALTH
300109576OtherRAILROAD MEDICARE
127103100OtherTXFIRSTCARE
P7702MedicaidNM
87468YOtherBLUE CROSS
134467306MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NM2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050211000817 TX Practitioner - Diagnostic Radiology 7517864283 Reassigns benefits to 1 organization
I20170831002022 NM Practitioner - Diagnostic Radiology 7517864283

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Texas a & M University System, HSC, College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical GroupGroup PAC ID 6901889393, 228 clinicians

Practice addresses (Care Compare)

4408 6TH St
Lubbock, TX 79416-4732
Phone (806) 791-0399

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group CurrentSince May 1, 2020 Accepting new patients
Covenant Medical Group CurrentSince May 1, 2020 Accepting new patients
Lubbock County Hospital District Diagnostic Radiology Past Accepting new patients

Locations

2215 Nashville Ave
Lubbock, TX 79410
Phone (806) 725-5228

3601 21st St
Lubbock, TX 79410
Phone (806) 791-0399

4408 6th St
Lubbock, TX 79416
Phone (806) 791-0399

Interoperability endpoints

  • Direct secure messaging: twindisch1662748@oc.providencedirect.org
  • Direct secure messaging: twindisch355858@ahs.direct-ci.com

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 2

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": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1073519419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 NASHVILLE AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101105",
            "telephone_number": "806-725-5844",
            "fax_number": "806-723-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 21ST ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101229",
            "telephone_number": "806-791-0399",
            "fax_number": "806-791-0373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINDISCH",
        "first_name": "THOMAS",
        "middle_name": "RICHARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "J2419",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TX",
            "license": "J2419",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "1146374",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300109576",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTCARE",
            "identifier": "127103100",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P7702",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "87468Y",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134467306",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.