Organization Active NPI

Genesis Radiology, P.a.

  • Diagnostic Radiology Physician
  • Plano, TX
National Provider Identifier
1154433746
Registry record updated Dec 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G7011 Issued in TX
Legal business name
GENESIS RADIOLOGY, P.A.
Practice address
2828 W Parker Rd
Plano, TX 75075-9153
Phone
(972) 599-1860
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2008

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

Authorized official

Name
Albert TesorieroNPI 1952339392
Title
Medical Director
Phone
(972) 599-1860

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
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X G7011 TX Primary

Addresses

Primary practice location

2828 W Parker Rd
Plano, TX 75075-9153

Mailing address

PO Box 864768
Plano, TX 75086-4768

Other identifiers 4

IdentifierTypeStateIssuer
180974600OtherTXDEPT OF LABOR
113724202MedicaidTX
8J8280OtherTXBCBS
1593231MedicaidLA

National Provider Directory

National Provider Directory

Locations

2828 W Parker Rd
Plano, TX 75075
Phone (972) 599-1860

2828 W Parker Rd
Ste B106F
Plano, TX 75075
Phone (972) 599-1860

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": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229472000000",
    "number": "1154433746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 864768",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750864768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 W PARKER RD",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750759153",
            "telephone_number": "972-599-1860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS RADIOLOGY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-12-17",
        "status": "A",
        "authorized_official_last_name": "TESORIERO",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "972-599-1860"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "G7011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "180974600",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113724202",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8J8280",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1593231",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.