Organization Active NPI

Robert J. Falconer, MD, PA

  • Surgery Physician
  • Palestine, TX
National Provider Identifier
1487784690
Registry record updated Nov 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
L4830 Issued in TX
Legal business name
ROBERT J. FALCONER, MD, PA
Practice address
123 Medical Dr
Suite a
Palestine, TX 75801-8510
Phone
(903) 729-6010
Fax
(903) 729-6886
NPI assigned
Mar 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2007

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

Authorized official

Name
Robert J Falconer, M.D.NPI 1235193848
Title
Owner Physician
Phone
(903) 729-6010

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X L4830 TX Primary

Addresses

Primary practice location

123 Medical Dr
Suite a
Palestine, TX 75801-8510

Mailing address

123 Medical Dr
Suite a
Palestine, TX 75801-8510
Phone (903) 729-6010

Other identifiers 2

IdentifierTypeStateIssuer
0032JJOtherTXBCBS TX PROVIDER #
154185601MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051107000291 TX Part B Supplier - Clinic/Group Practice 4688692882 Receives reassigned benefits from 1 practitioner
Practice locations: Palestine, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193961600000",
    "number": "1487784690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 MEDICAL DR",
            "address_2": "SUITE A",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "758018510",
            "telephone_number": "903-729-6010",
            "fax_number": "903-729-6886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 MEDICAL DR",
            "address_2": "SUITE A",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "758018510",
            "telephone_number": "903-729-6010",
            "fax_number": "903-729-6886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT J. FALCONER, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-11-02",
        "status": "A",
        "authorized_official_last_name": "FALCONER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "903-729-6010",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "TX",
            "license": "L4830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TX PROVIDER #",
            "identifier": "0032JJ",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154185601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palestine, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.