Eitan Podgaetz Gliksberg, MD

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

51235 Issued in MN

Practice address

3410 Worth St, Suite 235
Dallas, TX 75246

Phone

(469) 800-7370

NPI assigned

Oct 2, 2008

Last updated

Apr 8, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Thoracic Surgery

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baylor University Medical Center Hospital, Dallas, TX, CCN 450021
• Baylor Scott & White Heart & Vascular Hospital - Dallas Hospital, Dallas, TX, CCN 450851

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: epodgaetz271003@direct.sw.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Healthtexas Provider Network

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1760488936

  Surgery

  Medicare reassignment Care Compare group NPD
• Healthtexas Provider Network

  dba Symmetry Anesthesia

  • Anesthesiology Physician
  • Lakeway, TX
  • NPI 1104714583
  NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Plano, TX
  • NPI 1003811639
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baylor University Medical Center

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1447250253
  Care Compare affiliation
• Texas Heart Hospital of the Southwest LLC

  dba Baylor Scott & White Heart and Vascular Hospital - Dallas

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1609855139
  Care Compare affiliation

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

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649376000000",
    "number": "1689825119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 WORTH ST STE 235",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462071",
            "telephone_number": "469-800-7370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 WORTH ST, SUITE 235",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75246",
            "telephone_number": "469-800-7370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODGAETZ GLIKSBERG",
        "first_name": "EITAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-02",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "51235",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MN",
            "license": "51235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX LICENSE #",
            "identifier": "R0300",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "epodgaetz271003@direct.sw.org",
            "affiliation": "N",
            "address_1": "3410 Worth St, Suite 235",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "75246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Glyness Marie Poblete, FNP, ACNP
• Mark M. Podberezin, M.D.
• Keshav Poddar, MD
• Varsha Podduturi, M.D.
• David Alexander Podeszwa, MD
• Podiatric Medical Partners of Texas, PA (Jonathan M Kletz D P M PA)
• Podiatric Medical Partners of Texas, PA
• Podiatric Medical Partners of Texas, PA (Southwest Podiatry, LLP)
• Podiatric Medical Partners of Texas, PA (Comfort Podiatry, PA)
• Podiatric Medical Partners of Texas, PA (North Dallas Podiatry)

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.