Individual provider Active NPI

Brijesh S Gill, M.D.

  • Surgery Physician
  • Tyler, TX
National Provider Identifier
1346279502
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
K9284 Issued in TX
Practice address
800 E Dawson St
Tyler, TX 75701-2036
Phone
(903) 606-6400
Fax
(903) 606-1522
NPI assigned
Jul 1, 2006
Last updated
Feb 9, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X K9284 TX
Surgery Physician 208600000X K9284 TX Primary

Addresses

Primary practice location

800 E Dawson St
Tyler, TX 75701-2036

Mailing address

PO Box 301173
Dallas, TX 75303-1173
Phone (713) 500-3500

Other practice location 1

6410 Fannin St
1400
Houston, TX 77030-3000
Phone (832) 325-7125

Other identifiers 4

IdentifierTypeStateIssuer
158241301MedicaidTX
8F6695OtherTXBCBS
158241307MedicaidTX
1L0846OtherVAMEDICARE

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
I20100106000867 TX Practitioner - Critical Care (Intensivists)Practitioner - General Surgery 1557402906 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Dec 14, 2020 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Dec 14, 2020 Accepting new patients

Locations

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

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

Organizations & group practices 2

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": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1346279502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 301173",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753031173",
            "telephone_number": "713-500-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E DAWSON ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012036",
            "telephone_number": "903-606-6400",
            "fax_number": "903-606-1522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6410 Fannin St",
            "address_2": "1400",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770303000",
            "country_code": "US",
            "telephone_number": "832-325-7125",
            "fax_number": "713-512-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILL",
        "first_name": "BRIJESH",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "TX",
            "license": "K9284",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "K9284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158241301",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8F6695",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158241307",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1L0846",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.