Individual provider Active NPI

Eric Russel Dritsas, MD

  • Surgery Physician
  • Dallas, TX
National Provider Identifier
1396840542
Registry record updated May 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A77233 Issued in CA
Practice address
8128 Park Lane
Suite 130
Dallas, TX 75231-5908
Phone
(214) 361-1222
Fax
(214) 361-1205
NPI assigned
Sep 13, 2006
Last updated
May 7, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A77233 CA Primary

Addresses

Primary practice location

8128 Park Lane
Suite 130
Dallas, TX 75231-5908

Mailing address

2001 Butterfield Road
Suite 300
Downers Grove, IL 60515-1069
Phone (630) 725-2700

Other identifiers 1

IdentifierTypeStateIssuer
500612383MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A77233CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McKinney Surgeons PLLC Surgery Past Accepting new patients

Organizations & group practices 1

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430956800000",
    "number": "1396840542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD ROAD",
            "address_2": "SUITE 300",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151069",
            "telephone_number": "630-725-2700",
            "fax_number": "630-725-2783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8128 PARK LANE",
            "address_2": "SUITE 130",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752315908",
            "telephone_number": "214-361-1222",
            "fax_number": "214-361-1205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRITSAS",
        "first_name": "ERIC",
        "middle_name": "RUSSEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2015-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A77233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500612383",
            "state": "OR"
        }
    ],
    "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 May 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.