Individual provider Active NPI

Richard David Greczanik, D.O.

  • Family Medicine Physician
  • Tyler, TX
National Provider Identifier
1689823429
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R1957 Issued in TX
Practice address
3593 E Grande Blvd
Tyler, TX 75707-1400
Phone
(903) 839-2585
NPI assigned
Sep 17, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 58.001880 OH
Family Medicine Physician 207Q00000X 34.009584 OH
Family Medicine Physician 207Q00000X R1957 TX Primary

Addresses

Primary practice location

3593 E Grande Blvd
Tyler, TX 75707-1400

Mailing address

PO Box 846098
Dallas, TX 75284-2975
Phone (903) 324-6400

Other practice location 1

3802 Manhatton Dr
Tyler, TX 75701-9451
Phone (903) 509-8888

Other practice location 2

5414 S Broadway Ave
Tyler, TX 75703-1335
Phone (903) 581-1601

Other identifiers 10

IdentifierTypeStateIssuer
370175701MedicaidTX
75-0818167-022OtherTXTRICARE
75-2616977-001OtherTXTRICARE
75-2616977-129OtherTXTRICARE
P01877165OtherTXMEDICARE RAIL ROAD
8GQ047OtherTXBCBS
8GQ046OtherTXBCBS
370175702MedicaidTX
75-2616977-002OtherTXTRICARE
75-2616977-028OtherTXTRICARE

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
I20170404000813 TX Practitioner - Family Practice 5698813491 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34.009584OHMDFamily Medicine Physician
58.001880OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas Family Medicine CurrentSince Mar 6, 2017 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Mar 6, 2017 Accepting new patients
Mother Frances Hospital Regional Health Care Center CurrentSince Mar 6, 2017 Accepting new patients
Mercy Health Youngstown LLC Past Accepting new patients

Locations

3593 E Grande Blvd
Tyler, TX 75707
Phone (903) 606-1664

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

5414 S Broadway Ave
Tyler, TX 75703
Phone (903) 581-1601

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

3802 Manhatton Dr
Tyler, TX 75701
Phone (903) 509-8888

Interoperability endpoints

  • Direct secure messaging: rgreczanik140060@christushealth.direct-ci.net

Organizations & group practices 4

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": "1221609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1689823429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 846098",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752842975",
            "telephone_number": "903-324-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3593 E GRANDE BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757071400",
            "telephone_number": "903-839-2585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3802 Manhatton Dr",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757019451",
            "country_code": "US",
            "telephone_number": "903-509-8888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5414 S Broadway Ave",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757031335",
            "country_code": "US",
            "telephone_number": "903-581-1601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRECZANIK",
        "first_name": "RICHARD",
        "middle_name": "DAVID",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-17",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "58.001880",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34.009584",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R1957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370175701",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-0818167-022",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-129",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAIL ROAD",
            "identifier": "P01877165",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8GQ047",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8GQ046",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370175702",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-002",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-028",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.