Organization Active NPI

Frank P Reuter Jr MD PA

  • Geriatric Medicine (Internal Medicine) Physician
  • Tyler, TX
National Provider Identifier
1073821807
Registry record updated Dec 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
E4629 Issued in TX
Legal business name
FRANK P REUTER JR MD PA
Practice address
712 S Bois D Arc Ave
Tyler, TX 75701-1503
Phone
(903) 597-5579
Fax
(903) 597-5722
NPI assigned
Sep 14, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2013

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

Authorized official

Name
Dr. Frank P Reuter Jr., M.D.NPI 1144290412
Title
Owner
Phone
(903) 597-5579

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
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0300X E4629 TX Primary

Addresses

Primary practice location

712 S Bois D Arc Ave
Tyler, TX 75701-1503

Mailing address

712 S Bois D Arc Ave
Tyler, TX 75701-1503
Phone (903) 597-5579

Other identifiers 2

IdentifierTypeStateIssuer
1073821807OtherTXMEDICARE NPI
034143001MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101115001281 TX Part B Supplier - Clinic/Group Practice 4880889997 Receives reassigned benefits from 1 practitioner
Practice locations: Tyler, TX

National Provider Directory

National Provider Directory

Locations

712 S Bois D Arc Ave
Tyler, TX 75701
Phone (903) 597-5579

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": "1284422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386547200000",
    "number": "1073821807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 S BOIS D ARC AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011503",
            "telephone_number": "903-597-5579",
            "fax_number": "903-597-5722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 S BOIS D ARC AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011503",
            "telephone_number": "903-597-5579",
            "fax_number": "903-597-5722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANK P REUTER JR MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-14",
        "last_updated": "2013-12-09",
        "status": "A",
        "authorized_official_last_name": "REUTER",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-597-5579",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "TX",
            "license": "E4629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NPI",
            "identifier": "1073821807",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "034143001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2013; 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.