NPIMap

Organization Active NPI

Greenville Pulmonary Associates,PA

  • Critical Care Medicine (Internal Medicine) Physician
  • Greenville, TX
National Provider Identifier
1619008083
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
L7111 Issued in TX
Legal business name
GREENVILLE PULMONARY ASSOCIATES,PA
Practice address
4221 Ridgecrest Rd
Ste 107
Greenville, TX 75402-6005
Phone
(903) 454-9976
Fax
(903) 454-4509
NPI assigned
Mar 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Authorized official

Name
Dr. Mohan Parayil Philip, MDNPI 1124093471
Title
Physician
Phone
(903) 454-9976

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RC0200X L7111 TX Primary
Pulmonary Disease PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RP1001X L7111 TX
Sleep Medicine (Internal Medicine) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RS0012X L7111 TX

Addresses

Primary practice location

4221 Ridgecrest Rd
Ste 107
Greenville, TX 75402-6005

Mailing address

4221 Ridgecrest Rd
Ste 107
Greenville, TX 75402-6005
Phone (903) 454-9976

Other identifiers 1

IdentifierTypeStateIssuer
1616351-01MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031117000077 TX Part B Supplier - Clinic/Group Practice 8921912775 Receives reassigned benefits from 4 practitioners
Practice locations: Greenville, TX

National Provider Directory

National Provider Directory

Practitioners 4

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": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1619008083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4221 RIDGECREST RD",
            "address_2": "STE 107",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754026005",
            "telephone_number": "903-454-9976",
            "fax_number": "903-454-4509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4221 RIDGECREST RD",
            "address_2": "STE 107",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754026005",
            "telephone_number": "903-454-9976",
            "fax_number": "903-454-4509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENVILLE PULMONARY ASSOCIATES,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "PHILIP",
        "authorized_official_first_name": "MOHAN",
        "authorized_official_middle_name": "PARAYIL",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "903-454-9976",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "TX",
            "license": "L7111",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TX",
            "license": "L7111",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "TX",
            "license": "L7111",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1616351-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.