NPIMap

Individual provider Active NPI

Elijah Shaun Trout, D.O.

  • Diagnostic Radiology Physician
  • Katy, TX
National Provider Identifier
1811283930
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
Q7491 Issued in TX
Practice address
23107 Isthmus Cove CT
Katy, TX 77494-6501
Phone
(806) 831-1895
NPI assigned
Jun 27, 2011
Last updated
Jul 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 5101019560 MI
Diagnostic Radiology Physician 2085R0202X DO-04867 IA
Diagnostic Radiology Physician 2085R0202X Q7491 TX Primary

Addresses

Primary practice location

23107 Isthmus Cove CT
Katy, TX 77494-6501

Mailing address

23107 Isthmus Cove CT
Katy, TX 77494-6501
Phone (806) 831-1895

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, PR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170623000544 TX Practitioner - Diagnostic Radiology 7113219171 Reassigns benefits to 3 organizations
I20240404004388 PR Practitioner - Diagnostic Radiology 7113219171 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Lake Erie College of Osteopathic Medicine, Erie, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Radiologists and AssociatesGroup PAC ID 5092798645, 12 clinicians
High Plains Radiological Association LLPGroup PAC ID 9739172479, 36 clinicians

Practice addresses (Care Compare)

1719 Treasure Hills Blvd
Harlingen, TX 78550-8949
Phone (956) 682-9894

1901 Medi Park Dr
Suite 2050
Amarillo, TX 79106-2109
Phone (806) 355-3352

34 Calle Jacaguaz
Aguas Buenas, PR 00703-9626
Phone (866) 287-3198

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101019560MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
High Plains Radiological Association LLP Diagnostic Radiology CurrentSince Jul 1, 2017 Accepting new patients
Valley Radiologists & Associates Diagnostic Radiology CurrentSince Nov 1, 2023 Accepting new patients
Open Air Imaging Center, LLP CurrentSince Jul 1, 2017 Accepting new patients

Locations

1600 Wallace Blvd
Amarillo, TX 79106
Phone (806) 212-2000

1901 Medi Park Dr
Ste 2050
Amarillo, TX 79106
Phone (806) 355-3352

7400 Wallace Blvd
Amarillo, TX 79106
Phone (806) 351-8480

26 S Coria St
#M
Brownsville, TX 78520
Phone (956) 389-2060

1717 Treasure Hills Blvd
Harlingen, TX 78550
Phone (956) 389-3300

1719 Treasure Hills Blvd
Harlingen, TX 78550
Phone (956) 212-4388

Organizations & group practices 3

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.

Hospital & facility affiliations 5

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": "1309132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1811283930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23107 ISTHMUS COVE CT",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774946501",
            "telephone_number": "806-831-1895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23107 ISTHMUS COVE CT",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774946501",
            "telephone_number": "806-831-1895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROUT",
        "first_name": "ELIJAH",
        "middle_name": "SHAUN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-27",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "5101019560",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IA",
            "license": "DO-04867",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "Q7491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.