Active NPI
Silas Edwin Duncan, M.D.
- Vascular Surgery Physician
- Tyler, TX
National Provider Identifier
1508868001
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- D4981
- Practice address
- 700 Olympic Plaza Cir
Suite 510
Tyler, TX 75701-1951 - Phone
- (903) 595-2636
- Fax
- (903) 595-5560
- NPI assigned
- Aug 15, 2005
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | D4981 | TX | |
| Vascular Surgery Physician | 2086S0129X | D4981 | TX | Primary |
Addresses
Primary practice location
700 Olympic Plaza Cir
Suite 510
Tyler, TX 75701-1951
Mailing address
700 Olympic Plaza Cir
Suite 510
Tyler, TX 75701-1951
Phone (903) 595-2636
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MDD4981 | Other | TX | TX WC/IHC |
| 020028080 | Other | TX | RAILROAD MEDICARE |
| 2287588 | Other | TX | BLUELINK |
| 123940201 | Medicaid | TX | |
| 4568289 | Other | TX | AETNA |
| 752605101 | Other | TX | FEIN |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358985600000",
"number": "1508868001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 OLYMPIC PLAZA CIR",
"address_2": "SUITE 510",
"city": "TYLER",
"state": "TX",
"postal_code": "757011951",
"telephone_number": "903-595-2636",
"fax_number": "903-595-5560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 OLYMPIC PLAZA CIR",
"address_2": "SUITE 510",
"city": "TYLER",
"state": "TX",
"postal_code": "757011951",
"telephone_number": "903-595-2636",
"fax_number": "903-595-5560"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNCAN",
"first_name": "SILAS",
"middle_name": "EDWIN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-15",
"last_updated": "2013-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "TX",
"license": "D4981",
"primary": false
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "TX",
"license": "D4981",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TX WC/IHC",
"identifier": "MDD4981",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "020028080",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUELINK",
"identifier": "2287588",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "123940201",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4568289",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEIN",
"identifier": "752605101",
"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 Jan 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.