Organization Active NPI

Elizabeth a Jekot MD PA

  • Body Imaging Physician
  • Richardson, TX
National Provider Identifier
1669578761
Registry record updated Nov 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Body Imaging PhysicianTaxonomy code 2085B0100X
License
M00793 Issued in TX
Legal business name
ELIZABETH A JEKOT MD PA
Practice address
3301 E Renner Rd
Suite 100
Richardson, TX 75082-1801
Phone
(972) 442-7050
Fax
(214) 442-7075
NPI assigned
Sep 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2007

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

Authorized official

Name
Dr. Elizabeth A Jekot, MDNPI 1891773933
Title
Owner
Phone
(214) 442-7050

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085B0100X M00793 TX Primary

Addresses

Primary practice location

3301 E Renner Rd
Suite 100
Richardson, TX 75082-1801

Mailing address

PO Box 832265
Richardson, TX 75083-2265
Phone (972) 758-3598

Other identifiers 2

IdentifierTypeStateIssuer
00R68ROtherTXBCBS
084868101MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051021000345 TX Part B Supplier - Clinic/Group Practice 4981620655 Receives reassigned benefits from 2 practitioners
Practice locations: Richardson, TX

National Provider Directory

National Provider Directory
Tax ID family
Elizabeth a Jekot MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4708 Alliance Blvd
Ste 4
Plano, TX 75093
Phone (469) 814-5500

Practitioners & affiliated clinicians

Practitioners 3

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": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194912000000",
    "number": "1669578761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 832265",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750832265",
            "telephone_number": "972-758-3598",
            "fax_number": "972-599-9604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 E RENNER RD",
            "address_2": "SUITE 100",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750821801",
            "telephone_number": "972-442-7050",
            "fax_number": "214-442-7075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH A JEKOT MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2007-11-13",
        "status": "A",
        "authorized_official_last_name": "JEKOT",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-442-7050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Body Imaging",
            "state": "TX",
            "license": "M00793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00R68R",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084868101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2007; 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.