Active NPI
Edward Panousieris, DO
- Family Medicine Physician
- Mesquite, TX
National Provider Identifier
1578675864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- H2665
- Practice address
- 2696 N Galloway Ave
Suite 102
Mesquite, TX 75150 - Phone
- (972) 613-5500
- Fax
- (972) 613-5015
- NPI assigned
- Aug 31, 2006
- Last updated
- Jul 22, 2008
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | H2665 | TX | Primary |
Addresses
Primary practice location
2696 N Galloway Ave
Suite 102
Mesquite, TX 75150
Mailing address
2696 N Galloway Ave
Suite 102
Mesquite, TX 75150
Phone (972) 613-5500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 097269702 | Other | TX | TPI |
| 097269702 | Medicaid | TX |
Medicare participation
Medicare enrollment files- 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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Kansas City University of Med & Biosciences, College of Osteo Med, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2696 N Galloway Ave
Suite 102
Mesquite, TX 75150-6366
Phone (972) 613-5500
Hospital & facility affiliations
- Baylor Scott and White Medical Center Sunnyvale
- Baylor Scott and White Medical Center Lake Pointe
- Baylor University Medical Center
- Mesquite Rehabilitation Institute
- Mesquite Specialty Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H2265 | TX | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edward Panousieris, Dopa | Family Medicine | Current | Accepting new patients |
| North Texas Family Clinic PA | Past | Accepting new patients |
Locations
2696 N Galloway Ave
Ste 102
Mesquite, TX 75150
Phone (972) 613-5500
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.
-
- Family Medicine Physician
- Mesquite, TX
- NPI 1144652900
-
- Clinic/Center
- Mesquite, TX
- NPI 1861676231
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Dallas, TX
- NPI 1447250253
-
dba Baylor Scott & White Medical Center Lake Pointe
- General Acute Care Hospital
- Rowlett, TX
- NPI 1205018439
-
- Long Term Care Hospital
- Mesquite, TX
- NPI 1831146331
Long-term care hospital
-
dba Mesquite Rehabilitation Institute
- Rehabilitation Hospital
- Mesquite, TX
- NPI 1922321447
Inpatient rehabilitation facility
-
dba Baylor Scott & White Medical Center - Sunnyvale
- General Acute Care Hospital
- Sunnyvale, TX
- NPI 1255579389
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216684800000",
"number": "1578675864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2696 N GALLOWAY AVE",
"address_2": "SUITE 102",
"city": "MESQUITE",
"state": "TX",
"postal_code": "75150",
"telephone_number": "972-613-5500",
"fax_number": "972-613-5015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2696 N GALLOWAY AVE",
"address_2": "SUITE 102",
"city": "MESQUITE",
"state": "TX",
"postal_code": "75150",
"telephone_number": "972-613-5500",
"fax_number": "972-613-5015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANOUSIERIS",
"first_name": "EDWARD",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2008-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "H2665",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TPI",
"identifier": "097269702",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "097269702",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mesquite, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; 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.