Individual provider Active NPI

Darryl Dewitt Collins, M.D.

  • Family Medicine Physician
  • Portland, TX
National Provider Identifier
1720107493
Registry record updated Sep 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H7971 Issued in TX
Practice address
213 Cedar Dr Ste a
Portland, TX 78374-2913
Phone
(361) 777-2886
Fax
(361) 777-3667
NPI assigned
Mar 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X H7971 TX Primary

Addresses

Primary practice location

213 Cedar Dr Ste a
Portland, TX 78374-2913

Mailing address

213 Cedar Dr Ste a
Portland, TX 78374-2913
Phone (361) 777-2886

Other identifiers 1

IdentifierTypeStateIssuer
150017501MedicaidTX

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
I20111228000517 TX Practitioner - Family Practice 0749456531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Texas a & M University System, HSC, College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

213 Cedar Dr
Suite a
Portland, TX 78374-2913
Phone (361) 777-2886

Hospital & facility affiliations

  • Assist Home Health Home health agency, Corpus Christi, TX, CCN 747600
  • Siloe Home Health & Infusion, LLC Home health agency, Rockport, TX, CCN 679686

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H7971TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Darryl Dewitt Collins, M.D.,P.a. Family Medicine CurrentSince Apr 1, 2001 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients

Locations

213 Cedar Dr
Ste A
Portland, TX 78374
Phone (361) 777-2886

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220400000000",
    "number": "1720107493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 CEDAR DR STE A",
            "city": "PORTLAND",
            "state": "TX",
            "postal_code": "783742913",
            "telephone_number": "361-777-2886",
            "fax_number": "361-777-3667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 CEDAR DR STE A",
            "city": "PORTLAND",
            "state": "TX",
            "postal_code": "783742913",
            "telephone_number": "361-777-2886",
            "fax_number": "361-777-3667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "DARRYL",
        "middle_name": "DEWITT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2008-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H7971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150017501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, TX

Sources for this page

Verify at the official NPI Registry.