Individual provider Active NPI

El-Cid O Tajon, MD

  • Internal Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1821022021
Registry record updated Feb 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M3401 Issued in TX
Practice address
1300 W Terrell Ave FL 2
Fort Worth, TX 76104-2820
Phone
(817) 820-4906
Fax
(817) 820-4815
NPI assigned
Jul 11, 2006
Last updated
Feb 12, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M3401 TX Primary

Addresses

Primary practice location

1300 W Terrell Ave FL 2
Fort Worth, TX 76104-2820

Mailing address

1300 W Terrell Ave FL 2
Fort Worth, TX 76104-2820
Phone (817) 820-4906

Other identifiers 3

IdentifierTypeStateIssuer
179363003MedicaidTX
P00335607OtherTXRAIL ROAD MEDICARE
82557YOtherTXBLUE CROSS BLUE SHIELD

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
I20060330000355 TX Practitioner - Internal Medicine 4981612017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

1301 Pennsylvania Ave
Fort Worth, TX 76104-2122
Phone (817) 820-4906

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M3401TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group Current Accepting new patients
Texas Health Physicians Group Internal Medicine CurrentSince Jul 1, 2006 Accepting new patients
Texas Health Physicians Group CurrentSince Jul 1, 2006 Accepting new patients
Texas Health Harris Methodist Hospital Fort Worth Past Accepting new patients

Locations

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

1301 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 250-2000

341 Wheatfield Dr
Ste 100
Sunnyvale, TX 75182
Phone (972) 329-1996

Interoperability endpoints

  • Direct secure messaging: etajon26767@direct.texashealth.org
  • FHIR API: https://epproxy.texashealth.org/FHIR/api/FHIR/DSTU2/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360627200000",
    "number": "1821022021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W TERRELL AVE FL 2",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042820",
            "telephone_number": "817-820-4906",
            "fax_number": "817-820-4815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W TERRELL AVE FL 2",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042820",
            "telephone_number": "817-820-4906",
            "fax_number": "817-820-4815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAJON",
        "first_name": "EL-CID",
        "middle_name": "O",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2013-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M3401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179363003",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00335607",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "82557Y",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.