Arlington Infectious Disease Associates, PA

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

L0707 Issued in TX

Legal business name

ARLINGTON INFECTIOUS DISEASE ASSOCIATES, PA

Practice address

3132 Matlock Rd
Suite 309
Arlington, TX 76015-2910

Phone

(817) 417-0260

Fax

(817) 417-4834

NPI assigned

Oct 18, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Elleni Woldesenbet, M.D.NPI 1861459869

Title

Owner

Phone

(817) 417-0260

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

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

• Elleni Woldesenbet, M.D.

  • Infectious Disease Physician
  • Arlington, TX
  • NPI 1861459869
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1192665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197590400000",
    "number": "1083803787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2718 SHADOW WOOD DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760062724",
            "telephone_number": "817-608-0625",
            "fax_number": "817-810-9815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3132 MATLOCK RD",
            "address_2": "SUITE 309",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760152910",
            "telephone_number": "817-417-0260",
            "fax_number": "817-417-4834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARLINGTON INFECTIOUS DISEASE ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-18",
        "last_updated": "2007-12-14",
        "status": "A",
        "authorized_official_last_name": "WOLDESENBET",
        "authorized_official_first_name": "ELLENI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-417-0260",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "TX",
            "license": "L0707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TX",
            "identifier": "0094LZ",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC6184",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Arlington Mansfield Foot & Ankle Centers, PA
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• Infectious Disease Physician in Arlington, TX
• Providers in Arlington, TX by specialty
• Infectious Disease Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2007; 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.