Active NPI
Wayne E Hostetler, MD
- Neurology Physician
- Tyler, TX
National Provider Identifier
1487649844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- G7662
- Practice address
- 508 W 2ND St
Tyler, TX 75701-2942 - Phone
- (903) 526-4350
- Fax
- (800) 580-1493
- NPI assigned
- Sep 13, 2005
- Last updated
- Feb 24, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | G7662 | TX | Primary |
Addresses
Primary practice location
508 W 2ND St
Tyler, TX 75701-2942
Mailing address
PO Box 6396
Tyler, TX 75711-6396
Phone (903) 526-4350
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 163702701 | Medicaid | TX |
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)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Texas Neurology Associates, P.a. | Neurology | Past | Accepting new patients |
Interoperability endpoints
- https://fhir.meditouchehr.com/api/fhir/r4/
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.
-
- Neurology Physician
- Tyler, TX
- NPI 1972680130
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330041600000",
"number": "1487649844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6396",
"city": "TYLER",
"state": "TX",
"postal_code": "757116396",
"telephone_number": "903-526-4350",
"fax_number": "800-580-1493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "508 W 2ND ST",
"city": "TYLER",
"state": "TX",
"postal_code": "757012942",
"telephone_number": "903-526-4350",
"fax_number": "800-580-1493"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOSTETLER",
"first_name": "WAYNE",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-13",
"last_updated": "2012-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "TX",
"license": "G7662",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "163702701",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.