Organization Active NPI

Healey Urology Clinic, P.a.

  • Urology Physician
  • Port Arthur, TX
National Provider Identifier
1114021631
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
HEALEY UROLOGY CLINIC, P.A.
Practice address
3180 Central Mall Dr
Port Arthur, TX 77642-8039
Phone
(409) 729-6231
Fax
(409) 727-6537
NPI assigned
Sep 13, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Gordon Bruce Healey, M.D.NPI 1164427662
Title
President
Phone
(409) 729-6231

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
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

3180 Central Mall Dr
Port Arthur, TX 77642-8039

Mailing address

3180 Central Mall Dr
Port Arthur, TX 77642-8039
Phone (409) 729-6231

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050216000160 TX Part B Supplier - Clinic/Group Practice 5092767277 Receives reassigned benefits from 2 practitioners
Practice locations: Port Arthur, TX

National Provider Directory

National Provider Directory

Locations

3180 Central Mall Dr
Port Arthur, TX 77642
Phone (409) 729-2631

3770 Plaza Cir
Port Arthur, TX 77642
Phone (409) 983-1314

Practitioners & affiliated clinicians

Practitioners 2

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": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114021631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3180 CENTRAL MALL DR",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776428039",
            "telephone_number": "409-729-6231",
            "fax_number": "409-727-6537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 CENTRAL MALL DR",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776428039",
            "telephone_number": "409-729-6231",
            "fax_number": "409-727-6537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALEY UROLOGY CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HEALEY",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "409-729-6231",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Arthur, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.