Organization Active NPI

Hillcrest Internal Medicine PLLC

  • Internal Medicine Physician
  • Dallas, TX
National Provider Identifier
1285213017
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
HILLCREST INTERNAL MEDICINE PLLC
Practice address
12720 Hillcrest Rd Ste 625
Dallas, TX 75230-2163
Phone
(469) 830-9600
Fax
(469) 830-9601
NPI assigned
Apr 7, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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

Authorized official

Name
Renee Stock, DONPI 1194820621
Title
Partner/Owner
Phone
(972) 792-5700

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 PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

12720 Hillcrest Rd Ste 625
Dallas, TX 75230-2163

Mailing address

9330 LBJ Fwy Ste 800
Dallas, TX 75243-4310
Phone (972) 792-5700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211124000426 TX Part B Supplier - Clinic/Group Practice 4981094414 Receives reassigned benefits from 4 practitioners
Practice locations: Dallas, 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
45D2239600Hillcrest Internal Medicine, PLLC12720 Hillcrest Rd Suite 625, Dallas, TX 75230Certificate of waiverOct 12, 2027

National Provider Directory

National Provider Directory

Locations

12720 Hillcrest Rd
Ste 625
Dallas, TX 75230
Phone (469) 830-9600

Practitioners & affiliated clinicians

Practitioners 4

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": "1617753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631577600000",
    "number": "1285213017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9330 LBJ FWY STE 800",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752434310",
            "telephone_number": "972-792-5700",
            "fax_number": "214-506-1170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12720 HILLCREST RD STE 625",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302163",
            "telephone_number": "469-830-9600",
            "fax_number": "469-830-9601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLCREST INTERNAL MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-07",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A",
        "authorized_official_last_name": "STOCK",
        "authorized_official_first_name": "RENEE",
        "authorized_official_title_or_position": "PARTNER/OWNER",
        "authorized_official_telephone_number": "972-792-5700",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; 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.