Individual provider Active NPI

Phyllis J Frostenson, MD

  • Diagnostic Radiology Physician
  • Arlington, TX
National Provider Identifier
1679761787
Registry record updated Mar 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G6169 Issued in TX
Practice address
3100 Matlock Rd Ste 105
Arlington, TX 76015-2900
Phone
(817) 543-2412
Fax
(817) 543-2663
NPI assigned
Oct 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X G6169 TX Primary

Addresses

Primary practice location

3100 Matlock Rd Ste 105
Arlington, TX 76015-2900

Mailing address

PO Box 152409
Arlington, TX 76015-8409
Phone (817) 543-2412

Other identifiers 1

IdentifierTypeStateIssuer
126871606MedicaidTX

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080609000587 TX Practitioner - Diagnostic Radiology 4789754359 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of New Mexico School of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3100 Matlock Rd
Suite 105
Arlington, TX 76015-2900
Phone (817) 543-2412

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G6169TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Imaging & Medical Diagnostic Specialists, P.a. CurrentSince Feb 26, 1984 Accepting new patients
Radcare of Texas PLLC Diagnostic Radiology Past Accepting new patients

Locations

1119 W Randol Mill Rd
Arlington, TX 76012
Phone (817) 274-8267

3100 Matlock Rd
Ste 105
Arlington, TX 76015
Phone (817) 543-2412

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1679761787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 152409",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760158409",
            "telephone_number": "817-543-2412",
            "fax_number": "817-543-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 MATLOCK RD STE 105",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760152900",
            "telephone_number": "817-543-2412",
            "fax_number": "817-543-2663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FROSTENSON",
        "first_name": "PHYLLIS",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-15",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "G6169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126871606",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

Verify at the official NPI Registry.