Gregory Richard Tollefsbol, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA02058 Issued in TX

Practice address

2701 Prince George Ave
Suite 100
Desoto, TX 75115-2045

Phone

(972) 296-8888

Fax

(972) 780-9550

NPI assigned

Apr 30, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baylor Scott & White Medical Center- Waxahachie Hospital, Waxahachie, TX, CCN 450372

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gtollefsbol1137705@direct.sw.org
• Direct secure messaging: gtollefsbol@direct.meditouchehr.com

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.

• Healthtexas Provider Network

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1760488936
  Medicare reassignment Care Compare group
• Medhealth

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1912957200
  Medicare reassignment NPD
• Hephzibah Visiting Clinicians

  • Family Nurse Practitioner
  • Desoto, TX
  • NPI 1083101075
  Medicare reassignment
• Healthtexas Provider Network

  • Family Medicine Physician
  • Plano, TX
  • NPI 1003811639
  NPD
• Healthtexas Provider Network

  • Anesthesiology Physician
  • Lakeway, TX
  • NPI 1104714583
  NPD
• Medhealth

  • Urgent Care Clinic/Center
  • Grand Prairie, TX
  • NPI 1558762690
  NPD
• Advanced Pain & Rehabilitation Association PLLC

  • Physical Medicine & Rehabilitation Physician
  • Wylie, TX
  • NPI 1215404637
  NPD (past)
• Dallas Lung Consultants PA

  • Specialist
  • Desoto, TX
  • NPI 1295769206
  NPD (past)

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

• Baylor Medical Center at Waxahachie

  • General Acute Care Hospital
  • Waxahachie, TX
  • NPI 1265430177
  Care Compare affiliation

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

{
    "created_epoch": "1177891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194220800000",
    "number": "1487874624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 PRINCE GEORGE AVE",
            "address_2": "SUITE 100",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152045",
            "telephone_number": "972-296-8888",
            "fax_number": "972-780-9550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 PRINCE GEORGE AVE",
            "address_2": "SUITE 100",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152045",
            "telephone_number": "972-296-8888",
            "fax_number": "972-780-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLLEFSBOL",
        "first_name": "GREGORY",
        "middle_name": "RICHARD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-30",
        "last_updated": "2007-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA02058",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA02058",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Tichana
• Tni Health Care Services, Inc.
• TNT Medical - a Home Healthcare Agency
• Todd J Ayars DDS, PA
• Elizabeth Jean Todd, M.S., CCC-SLP
• Tomorrow and Beyond, PLLC
• Tork Terapi PLLC
• Robert E Torti, MD
• Mark D Towns, M.D.
• Suzana Chau Tran, FNP

• Physician Assistant in Desoto, TX
• Providers in Desoto, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.