Individual provider Active NPI

David P Dipaolo, MD

  • Diagnostic Radiology Physician
  • Tyler, TX
National Provider Identifier
1376532820
Registry record updated Oct 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
J8993 Issued in TX
Practice address
11937 US Highway 271
Tyler, TX 75708-3154
Phone
(903) 877-3451
NPI assigned
Oct 18, 2005
Last updated
Oct 28, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X J8993 TX Primary

Addresses

Primary practice location

11937 US Highway 271
Tyler, TX 75708-3154

Mailing address

PO Box 731912
Dallas, TX 75373-1912
Phone (903) 877-7777

Other identifiers 1

IdentifierTypeStateIssuer
118154702MedicaidTX

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
I20091205000202 TX Practitioner - Diagnostic Radiology 0042359994 Reassigns benefits to 5 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Imaging LLC Diagnostic Radiology CurrentSince Nov 18, 2015 Accepting new patients
North Star MRI LP CurrentSince Aug 29, 2019 Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince Oct 4, 2016 Accepting new patients
Elite Imaging, LLC Diagnostic Radiology CurrentSince Nov 18, 2015 Accepting new patients
North Star GV, LP CurrentSince Aug 1, 2018 Accepting new patients
Blue Star Radiology Associates Diagnostic Radiology CurrentSince Jul 15, 2018 Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince Oct 4, 2016 Accepting new patients
Pine Ridge Indian Health Service Hospital Current Accepting new patients
Stat Portable X-Ray Inc CurrentSince Apr 1, 2017 Accepting new patients
Quantum Medical Radiology of California, P.C. Diagnostic Radiology Past Accepting new patients
Insight Health Corp Past Accepting new patients

Locations

21118 Union Tpke
Oakland Gdns, NY 11364
Phone (718) 217-8000

997 Raintree Cir
Ste 110
Allen, TX 75013

1 Cowboys Way
Ste 150
Frisco, TX 75034
Phone (214) 647-6165

2535 Ira E Woods Ave
Ste 101
Grapevine, TX 76051

Organizations & group practices 11

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": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382918400000",
    "number": "1376532820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 731912",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753731912",
            "telephone_number": "903-877-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11937 US HIGHWAY 271",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757083154",
            "telephone_number": "903-877-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIPAOLO",
        "first_name": "DAVID",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2013-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "J8993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118154702",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.