Individual provider Active NPI

Alfonso E. Pino III, MD

  • Anesthesiology Physician
  • Dallas, TX
National Provider Identifier
1265483812
Registry record updated Jul 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
J4441 Issued in TX
Practice address
11910 Greenville Avenue
Suite 650
Dallas, TX 75243-3596
Phone
(214) 373-9092
Fax
(214) 373-9250
NPI assigned
May 16, 2006
Last updated
Jul 10, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X J4441 TX Primary

Addresses

Primary practice location

11910 Greenville Avenue
Suite 650
Dallas, TX 75243-3596

Mailing address

P.O. Box 741475
Dallas, TX 75374-1475
Phone (214) 373-9092

Other identifiers 5

IdentifierTypeStateIssuer
50051739OtherTXRAILROAD MEDICARE
5125471OtherTXAETNA
100346901MedicaidTX
82130FOtherTXBLUE CROSS BLUE SHIELD TX
97384OtherTXAMERIGROUP

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
I20080807000523 TX Practitioner - AnesthesiologyPractitioner - Family Practice 6002914165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.22 of 100Reported as group
Quality
79.08
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Anesthesia & Pain Management Consultants, LLP Anesthesiology CurrentSince Sep 1, 1996 Accepting new patients
Allied Anesthesia Associates, LLP Anesthesiology Past Accepting new patients
Rapimed, LLC Past Accepting new patients

Locations

11910 Greenville Ave
Ste 650
Dallas, TX 75243
Phone (214) 373-9092

14114 Dallas Pkwy
Ste 200
Dallas, TX 75254
Phone (214) 373-9092

14850 Montfort Dr
Ste 200
Dallas, TX 75254
Phone (214) 373-9250

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247184000000",
    "number": "1265483812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 741475",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753741475",
            "telephone_number": "214-373-9092",
            "fax_number": "214-373-9250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11910 GREENVILLE AVENUE",
            "address_2": "SUITE 650",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752433596",
            "telephone_number": "214-373-9092",
            "fax_number": "214-373-9250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINO",
        "first_name": "ALFONSO",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2009-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "J4441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "50051739",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5125471",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100346901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD TX",
            "identifier": "82130F",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "97384",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.