Organization Active NPI

Northeast Tarrant Internal Medicine Associates

  • Internal Medicine Physician
  • Euless, TX
National Provider Identifier
1215007570
Registry record updated Feb 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
NORTHEAST TARRANT INTERNAL MEDICINE ASSOCIATES
Practice address
469 Westpark Way
Euless, TX 76040-3957
Phone
(817) 283-2888
Fax
(817) 358-5511
NPI assigned
Nov 8, 2006
Last updated
Feb 16, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2011

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

Authorized official

Name
Stephen R Buksh, M.D.NPI 1427053396
Title
Managing Partner
Phone
(817) 283-2888

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
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

469 Westpark Way
Euless, TX 76040-3957

Mailing address

469 Westpark Way
Euless, TX 76040-3957
Phone (817) 283-2888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040610000152 TX Part B Supplier - Clinic/Group Practice 4688657034 Receives reassigned benefits from 12 practitioners
Practice locations: Euless, TX; Fort Worth, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0485154NE Tarrant Internal Medicine Assoc, LLP469 Westpark Way, Euless, TX 76040Certificate of waiverDec 31, 2027

National Provider Directory

National Provider Directory

Locations

469 Westpark Way
Euless, TX 76040
Phone (817) 283-2888

469 Westpark Way
#200
Euless, TX 76040
Phone (817) 283-2888

Practitioners & affiliated clinicians

Practitioners 12

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": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297814400000",
    "number": "1215007570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "469 WESTPARK WAY",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760403957",
            "telephone_number": "817-283-2888",
            "fax_number": "817-358-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "469 WESTPARK WAY",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760403957",
            "telephone_number": "817-283-2888",
            "fax_number": "817-358-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST TARRANT INTERNAL MEDICINE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2011-02-16",
        "status": "A",
        "authorized_official_last_name": "BUKSH",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "817-283-2888",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Euless, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.