Individual provider Active NPI

Jason Nirgiotis, MD

  • Pediatric Surgery Physician
  • Amarillo, TX
National Provider Identifier
1124032115
Registry record updated May 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
H3828 Issued in TX
Practice address
1400 S Coulter St
Amarillo, TX 79106-1786
Phone
(806) 414-9800
Fax
(806) 354-5689
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X H3828 TX
Pediatric Surgery Physician 2086S0120X H3828 TX Primary

Addresses

Primary practice location

1400 S Coulter St
Amarillo, TX 79106-1786

Mailing address

1400 Wallace Blvd
Amarillo, TX 79106-1708
Phone (806) 414-9800

Other identifiers 4

IdentifierTypeStateIssuer
131497307MedicaidTX
J8692MedicaidNM
100050670 AMedicaidOK
131497308MedicaidTX

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
I20050503000500 TX Practitioner - Pediatric MedicinePractitioner - Other (Physician) 6305885963 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Amarillo Pediatrics CurrentSince Nov 1, 2013 Accepting new patients
Texas Tech University Health Sciences Center Amarillo Current Accepting new patients
Texas Tech University Health Sciences Center Amarillo Current Accepting new patients
Texas Tech University Health Sciences Center CurrentSince Nov 1, 2013 Accepting new patients
Texas Tech Univeristy Health Sciences Center Lubbock Current Accepting new patients
Texas Tech University Health Sciences Center Amarillo Current Accepting new patients
Northwest Texas Healthcare System Inc Past Accepting new patients
Bsa Hospital LLC Past Accepting new patients
Texas Tech University Health Sciences Center El Paso Past Accepting new patients

Locations

1400 Wallace Blvd
Amarillo, TX 79106
Phone (806) 354-5585

1400 S Coulter St
Amarillo, TX 79106
Phone (806) 354-5600

Interoperability endpoints

  • Direct secure messaging: jasonnirgiotis@texastech.allscriptsdirect.net

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463097600000",
    "number": "1124032115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 WALLACE BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061708",
            "telephone_number": "806-414-9800",
            "fax_number": "806-354-5689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S COULTER ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061786",
            "telephone_number": "806-414-9800",
            "fax_number": "806-354-5689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIRGIOTIS",
        "first_name": "JASON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2016-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "H3828",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "TX",
            "license": "H3828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131497307",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "J8692",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100050670 A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131497308",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.