Individual provider Active NPI

Brian J Kingston, MD

  • Family Medicine Physician
  • Greeley, CO
National Provider Identifier
1356345391
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K2052 Issued in TX
Practice address
2429 35TH Ave
Greeley, CO 80634-4171
Phone
(303) 338-4545
NPI assigned
Jun 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 50704 CO
Family Medicine Physician 207Q00000X 52296 KY
Family Medicine Physician 207Q00000X K2052 TX Primary

Addresses

Primary practice location

2429 35TH Ave
Greeley, CO 80634-4171

Mailing address

10350 E Dakota Ave
Denver, CO 80247-1314

Other practice location 1

2195 Harrodsburg Rd Ste 125
Lexington, KY 40504-3504
Phone (859) 257-1000

Other practice location 2

3593 E Grande Blvd
Tyler, TX 75707-1400
Phone (903) 839-2582

Other practice location 3

8934 S Broadway Ave Ste 448
Tyler, TX 75703-5475
Phone (903) 606-5100

Other identifiers 5

IdentifierTypeStateIssuer
0085HBOtherTXBCBS ID#
42938368MedicaidCO
024616OtherCOKASIER COMMERCIAL NUMBER
130895907MedicaidTX
080179674OtherTXRAILROAD MEDICARE ID#

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

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
I20081124000538 TX Practitioner - Family Practice 9436219201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Texas Tech University Health Science Center School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

105 Zeid Blvd
Henderson, TX 75652-6070
Phone (903) 595-2283

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

PO Box
Suite 846098
Dallas, TX 75284-6098

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
94.26
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50704COMDFamily Medicine Physician
52296KYMDFamily Medicine Physician
K2052TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas Family Medicine CurrentSince Nov 4, 2024 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Nov 4, 2024 Accepting new patients
University of Kentucky Past Accepting new patients

Locations

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

8934 S Broadway Ave
Ste 448
Tyler, TX 75703
Phone (903) 606-5100

3593 E Grande Blvd
Tyler, TX 75707
Phone (903) 606-1664

Interoperability endpoints

  • Direct secure messaging: bkingston429892@christushealth.direct-ci.net

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1356345391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10350 E DAKOTA AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802471314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2429 35TH AVE",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806344171",
            "telephone_number": "303-338-4545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2195 Harrodsburg Rd Ste 125",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405043504",
            "country_code": "US",
            "telephone_number": "859-257-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3593 E Grande Blvd",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757071400",
            "country_code": "US",
            "telephone_number": "903-839-2582",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8934 S Broadway Ave Ste 448",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757035475",
            "country_code": "US",
            "telephone_number": "903-606-5100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINGSTON",
        "first_name": "BRIAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "50704",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "52296",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K2052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID#",
            "identifier": "0085HB",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42938368",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KASIER COMMERCIAL NUMBER",
            "identifier": "024616",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130895907",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE ID#",
            "identifier": "080179674",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "CAREQUALITY",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2429 35th Ave",
            "city": "Greeley",
            "state": "CO",
            "country_code": "US",
            "postal_code": "806344171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.