Georgetown Pulmonary Associates, P.a.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

L0787 Issued in TX

Legal business name

GEORGETOWN PULMONARY ASSOCIATES, P.A.

Practice address

1900 Scenic Drive
Suite 2208
Georgetown, TX 78626-7703

Phone

(512) 819-0132

Fax

(512) 819-9335

NPI assigned

Jul 30, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Dominic R Dekeratry, M.D.NPI 1326007816

Title

President

Phone

(512) 819-0132

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 8

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

• Dominic R. Dekeratry, M.D.

  • Pulmonary Disease Physician
  • Georgetown, TX
  • NPI 1326007816

  Critical Care Medicine

  Medicare reassignment Care Compare group NPD Authorized official
• Esther L Fields, D.O.

  • Pulmonary Disease Physician
  • Georgetown, TX
  • NPI 1366616203

  Critical Care Medicine

  Medicare reassignment Care Compare group NPD
• Audrey Ngoc Nguyen, MD

  • Pulmonary Disease Physician
  • Houston, TX
  • NPI 1205030889

  Critical Care Medicine

  Medicare reassignment Care Compare group NPD
• Sean Richard Davidson, MD

  • Pulmonary Disease Physician
  • Lees Summit, MO
  • NPI 1891292033

  TX

  Medicare reassignment Care Compare group NPD
• Eric Donald Graber

  • Physician Assistant
  • Palm Harbor, FL
  • NPI 1003659210

  TX

  Medicare reassignment Care Compare group
• Jonathan Ram, MD

  • Pulmonary Disease Physician
  • Temple, TX
  • NPI 1750648572
  Medicare reassignment NPD
• Katherine Wentworth, PA-C

  • Physician Assistant
  • Georgetown, TX
  • NPI 1265002141
  Medicare reassignment
• Makinze Maiden

  • Physician Assistant
  • Rapid City, SD
  • NPI 1942987524

  TX

  Medicare reassignment

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

{
    "created_epoch": "1248912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540771200000",
    "number": "1639300288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 679706",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752679706",
            "telephone_number": "512-819-0132",
            "fax_number": "512-819-9335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SCENIC DRIVE",
            "address_2": "SUITE 2208",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786267703",
            "telephone_number": "512-819-0132",
            "fax_number": "512-819-9335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGETOWN PULMONARY ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-30",
        "last_updated": "2018-10-29",
        "status": "A",
        "authorized_official_last_name": "DEKERATRY",
        "authorized_official_first_name": "DOMINIC",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-819-0132",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "TX",
            "license": "L0787",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TX",
            "license": "L0787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2064198-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Georgetown Orthopedics
• Georgetown Pediatric Dentistry, LLC (Cove Pediatric Dentistry & Orthodontics)
• Georgetown Physical Therapy, LLC
• Georgetown Professional Massage and Wellness LLC
• Georgetown Psychological Services PLLC
• Georgetown Radiation Oncology PLLC
• Georgetown Radiology Associates, PLLC.
• Georgetown Sleep Center, P.a.
• Georgetown SNF Operations LLC (Estrella Oaks Rehabilitation and Care Center)
• Georgetown Vision Center PLLC

• Pulmonary Disease Physician in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Pulmonary Disease Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2018; 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.