Active NPI
Texas Radiology Associates LLP
- Diagnostic Radiology Physician
- Honolulu, HI
National Provider Identifier
1083990717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- Legal business name
- TEXAS RADIOLOGY ASSOCIATES LLP
- Practice address
- 460 Ena Rd
200
Honolulu, HI 96815-1779 - Phone
- (972) 867-7862
- Fax
- (972) 612-1623
- NPI assigned
- Oct 26, 2011
- Last updated
- Sep 9, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Ted S Wen, M.D.
- Title
- Partner
- Phone
- (972) 867-7862
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | NU | Primary |
Addresses
Primary practice location
460 Ena Rd
200
Honolulu, HI 96815-1779
Mailing address
PO Box 2285
Indianapolis, IN 46206-2285
Phone (866) 437-9810
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 218812001 | Medicaid | TX | |
| DC0892 | Other | TX | RR MEDICARE |
| 009767 | Other | TX | BCBS |
| 081568002 | Medicaid | TX | |
| 081568001 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in HI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120120000775 | HI | Part B Supplier - Clinic/Group Practice | 3779578000 |
Receives reassigned benefits from 17 practitioners Practice locations: Honolulu, HI |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider DirectoryMember organizations 1
Organizations listed as members of this organization in the National Provider Directory.
Locations
460 Ena Rd
#200
Honolulu, HI 96815
Practitioners & affiliated clinicians
Practitioners 18
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319587200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1378684800000",
"number": "1083990717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2285",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462062285",
"telephone_number": "866-437-9810",
"fax_number": "469-757-1095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "460 ENA RD",
"address_2": "200",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968151779",
"telephone_number": "972-867-7862",
"fax_number": "972-612-1623"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TEXAS RADIOLOGY ASSOCIATES LLP",
"organizational_subpart": "NO",
"enumeration_date": "2011-10-26",
"last_updated": "2013-09-09",
"status": "A",
"authorized_official_last_name": "WEN",
"authorized_official_first_name": "TED",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "PARTNER",
"authorized_official_telephone_number": "972-867-7862",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "218812001",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "DC0892",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "009767",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "081568002",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "081568001",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Honolulu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 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.