Individual provider Active NPI

Gerard Poche, M.D.

  • Anesthesiology Physician
  • Fort Worth, TX
National Provider Identifier
1073584561
Registry record updated Dec 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
F7059 Issued in TX
Practice address
1000 Houston Street
Suite 200
Fort Worth, TX 76102
Phone
(817) 336-0551
Fax
(817) 339-3940
NPI assigned
Feb 1, 2006
Last updated
Dec 21, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X F7059 TX Primary

Addresses

Primary practice location

1000 Houston Street
Suite 200
Fort Worth, TX 76102

Mailing address

1000 Houston Street
Suite 200
Fort Worth, TX 76102
Phone (817) 336-0551

Other identifiers 1

IdentifierTypeStateIssuer
128035607MedicaidTX

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
I20041016000093 TX Practitioner - Anesthesiology 7315907060 Practice locations: Tyler, TX

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F7059TXMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sheridan Healthcare of North Texas PA Anesthesiology Past Accepting new patients
Plaza Anesthesia Consultants, PLLC Anesthesiology Past Accepting new patients
Neurodiagnostics Tex Inc Past Accepting new patients
Plaza Anesthesia Group P.L.L.C. Anesthesiology Past Accepting new patients
Northstar Anesthesia, PA Anesthesiology Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: gerard.poche@cndpa.directbygreenway.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450656000000",
    "number": "1073584561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HOUSTON STREET",
            "address_2": "SUITE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76102",
            "telephone_number": "817-336-0551",
            "fax_number": "817-339-3940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HOUSTON STREET",
            "address_2": "SUITE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76102",
            "telephone_number": "817-336-0551",
            "fax_number": "817-339-3940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POCHE",
        "first_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2015-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "F7059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128035607",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.