Individual provider Active NPI

Timothy John Georgelas, MD

  • Diagnostic Radiology Physician
  • Richardson, TX
National Provider Identifier
1184688970
Registry record updated Apr 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G2140 Issued in TX
Practice address
403 W Campbell Rd
Suite 201
Richardson, TX 75080-3465
Phone
(972) 498-4000
NPI assigned
Apr 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X G2140 TX Primary

Addresses

Primary practice location

403 W Campbell Rd
Suite 201
Richardson, TX 75080-3465

Mailing address

PO Box 1888
Greenville, TX 75403
Phone (800) 945-2455

Other identifiers 1

IdentifierTypeStateIssuer
8U5020OtherBCBS

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
I20051208000549 TX Practitioner - Diagnostic Radiology 3678594405 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Uniformed Services Uhs Fe Hebert School of Med, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
GMN AssociatesGroup PAC ID 6305867128, 2 clinicians

Practice addresses (Care Compare)

2831 E President George Bush Hwy
Richardson, TX 75082-3561
Phone (469) 204-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G2140TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center El Paso Current Accepting new patients
GMN Associates Diagnostic Radiology CurrentSince Aug 1, 2005 Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Jul 1, 2020 Accepting new patients
GMN Associates Diagnostic Radiology CurrentSince Aug 1, 2005 Accepting new patients
Texas Tech University Health Sciences Center CurrentSince Jul 1, 2020 Accepting new patients
US Radiology Partners of Texas Inc Diagnostic Radiology Past Accepting new patients

Locations

4801 Alberta Ave
El Paso, TX 79905
Phone (915) 215-5200

4815 Alameda Ave
El Paso, TX 79905
Phone (915) 215-6000

401 W Campbell Rd
Richardson, TX 75080
Phone (940) 384-3535

2831 George Bush Hwy
Richardson, TX 75082
Phone (469) 204-1000

403 W Campbell Rd
Ste 205
Richardson, TX 75080
Phone (972) 498-8620

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207872000000",
    "number": "1184688970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1888",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "75403",
            "telephone_number": "800-945-2455",
            "fax_number": "903-453-2541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 W CAMPBELL RD",
            "address_2": "SUITE 201",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803465",
            "telephone_number": "972-498-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGELAS",
        "first_name": "TIMOTHY",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2008-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "G2140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8U5020",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

Verify at the official NPI Registry.