Individual provider Active NPI

Raleigh R Gleason III, M.D.

  • Pulmonary Disease Physician
  • Fort Worth, TX
National Provider Identifier
1316931876
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
H0387 Issued in TX
Practice address
1201 Fairmount Ave
Fort Worth, TX 76104-4215
Phone
(817) 335-5288
Fax
(817) 338-0927
NPI assigned
Sep 9, 2005
Last updated
Jul 25, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X H0387 TX
Pulmonary Disease Physician 207RP1001X H0387 TX Primary

Addresses

Primary practice location

1201 Fairmount Ave
Fort Worth, TX 76104-4215

Mailing address

601 Omega Dr Ste 208
Arlington, TX 76014-2075
Phone (817) 465-5881

Other practice location 1

1101 S Main St
Fort Worth, TX 76104-4802
Phone (817) 321-4700

Other identifiers 1

IdentifierTypeStateIssuer
127732904MedicaidTX

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
I20040602001484 TX Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists)Practitioner - Family Practice 1153303235 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
University of Texas Southwestern Medical School at Dallas, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of TarrantGroup PAC ID 1456315571, 6 clinicians

Practice addresses (Care Compare)

1101 S Main St
Fort Worth, TX 76104-4802
Phone (817) 321-4700

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tarrant Pulmonary Associates LLC Pulmonary Disease CurrentSince Nov 1, 2022 Accepting new patients
County of Tarrant CurrentSince Oct 1, 2019 Accepting new patients
County of Tarrant Current Accepting new patients
Texas Pulmonary & Critical Care Consultants, PA Critical Care Medicine PastSince Aug 12, 2019 Accepting new patients

Locations

601 Omega Dr
Ste 208
Arlington, TX 76014
Phone (817) 465-5881

1101 S Main St
Ste 2425
Fort Worth, TX 76104
Phone (817) 321-4700

1101 S Main St
Ft Worth, TX 76104
Phone (817) 321-4700

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BHHJCD

Organizations & group practices 5

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": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1316931876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 OMEGA DR STE 208",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760142075",
            "telephone_number": "817-465-5881",
            "fax_number": "817-465-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 FAIRMOUNT AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044215",
            "telephone_number": "817-335-5288",
            "fax_number": "817-338-0927"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 S Main St",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761044802",
            "country_code": "US",
            "telephone_number": "817-321-4700",
            "fax_number": "817-850-2372",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLEASON",
        "first_name": "RALEIGH",
        "middle_name": "R",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "TX",
            "license": "H0387",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TX",
            "license": "H0387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127732904",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.