Individual provider Active NPI

Spiros Manolidis, M.D

  • Otolaryngology Physician
  • Grapevine, TX
National Provider Identifier
1205976008
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
K4141 Issued in TX
Practice address
1600 W College St Ste 555
Grapevine, TX 76051-3589
Phone
(817) 329-6798
Fax
(817) 329-7801
NPI assigned
Feb 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X K4141 TX Primary

Addresses

Primary practice location

1600 W College St Ste 555
Grapevine, TX 76051-3589

Mailing address

P.O. Box 961205
Fort Worth, TX 76161-1205
Phone (817) 740-8450

Other practice location 1

501 Saunders Ave Ste 320
Tyler, TX 75702-7524
Phone (903) 606-5140

Other identifiers 1

IdentifierTypeStateIssuer
118066305MedicaidTX

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
I20170906000656 TX Practitioner - Otolaryngology 2567423726 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Health Care PLLCGroup PAC ID 7214840867, 363 clinicians
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

1600 W College St
555 Privia Med GRP N TX
Grapevine, TX 76051-3589
Phone (817) 329-6798

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

800 E Dawson St
Christus Trinity Clinic
Tyler, TX 75701-2036
Phone (903) 510-1186

PO Box
Suite 846098
Dallas, TX 75284-6098

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K4141TXMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Care, P.L.L.C. Current Accepting new patients
Christus Trinity Clinic Texas CurrentSince Oct 1, 2023 Accepting new patients
Texas Health Care, P.L.L.C. Otolaryngology CurrentSince Oct 1, 2017 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Oct 1, 2023 Accepting new patients
Texas Health Care, P.L.L.C. Otolaryngology CurrentSince Oct 1, 2017 Accepting new patients
Trustees of Columbia University in the City of New York Otolaryngology Past Accepting new patients
Baylor College of Medicine Past Accepting new patients
Trustees of Columbia University in the Department of Otolaryngology Past Accepting new patients
Baylor College of Medicine Otolaryngology Past Accepting new patients

Locations

3500 Gaston Ave
Dallas, TX 75246

2821 Lackland Rd
Ste 300
Ft Worth, TX 76116
Phone (817) 740-8400

1600 W College St
Ste 555
Grapevine, TX 76051
Phone (817) 310-0020

6700 Buenos Aires Dr
North Richlnd Hls, TX 76180
Phone (817) 281-8245

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

501 Saunders Ave
Ste 320
Tyler, TX 75702
Phone (903) 606-4300

920 Santa Fe Dr
Ste 103
Weatherford, TX 76086
Phone (817) 339-8855

Interoperability endpoints

  • Direct secure messaging: spiros.manolidis.p1@direct.thc.nextgenshare.com
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: spiros.manolidis.1@863.direct.athenahealth.com
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • Direct secure messaging: smanolidis336116@christushealth.direct-ci.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1205976008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 961205",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761611205",
            "telephone_number": "817-740-8450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W COLLEGE ST STE 555",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513589",
            "telephone_number": "817-329-6798",
            "fax_number": "817-329-7801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Saunders Ave Ste 320",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757027524",
            "country_code": "US",
            "telephone_number": "903-606-5140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANOLIDIS",
        "first_name": "SPIROS",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "K4141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118066305",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grapevine, TX

Sources for this page

Verify at the official NPI Registry.