Individual provider Active NPI

Paul Anthony Critelli, MD

  • Surgery Physician
  • Tyler, TX
National Provider Identifier
1831351790
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
Q6618 Issued in TX
Practice address
11937 US Highway 271
Tyler, TX 75708-3154
Phone
(903) 877-8790
NPI assigned
Jul 1, 2008
Last updated
Jun 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X Q6618 TX Primary
Plastic and Reconstructive Surgery Physician 2086S0122X Q6618 TX

Addresses

Primary practice location

11937 US Highway 271
Tyler, TX 75708-3154

Mailing address

11937 US Highway 271
Tyler, TX 75708-3154
Phone (903) 877-8790

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
I20160831002536 TX Practitioner - Plastic and Reconstructive SurgeryPractitioner - General Surgery 9638465529 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: General Surgery
Education
University of Texas Medical School at Houston, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

11937 US Hwy 271
Tyler, TX 75708-3154
Phone (903) 877-7200

18118 FM 344
Flint, TX 75762-6010
Phone (903) 825-3292

700 Olympic Plaza Cir
Tyler, TX 75701-1952

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy47
Melanoma (skin cancer) excision20
Removal of tissue15
Removal of skin lesions1-10
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q6618TXMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Health Science Center at Tyler-Facility-Physician CurrentSince Jan 1, 2018 Accepting new patients
Concord Medical Group PLLC CurrentSince Jun 27, 2017 Accepting new patients
Etmc Physician Group Inc. CurrentSince Feb 1, 2022 Accepting new patients
Etmc Physician Group Inc. CurrentSince Feb 1, 2022 Accepting new patients
University of Texas Health Science Center at Tyler-Facilty-Physician CurrentSince Jan 1, 2018 Accepting new patients
Concord Medical Group of Texas PLLC CurrentSince Jun 27, 2017 Accepting new patients
Vohra Post Acute Care Physicians of Texas, PLLC CurrentSince Jun 26, 2017 Accepting new patients

Locations

1201 Clarks Dr
Abilene, TX 79602
Phone (325) 670-9185

3830 Mustang Rd
Alvin, TX 77511
Phone (281) 585-8484

401 W Arbrook Blvd
Arlington, TX 76014
Phone (817) 466-3094

5800 W Baker Rd
Baytown, TX 77520
Phone (281) 424-4541

2660 Brickyard Rd
Beaumont, TX 77703
Phone (406) 892-1533

17218 Preston Rd
Ste 2000
Dallas, TX 75252
Phone (469) 518-8472

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

1 Avenue N
Haskell, TX 79521
Phone (940) 228-4321

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

102 W Henderson St
Overton, TX 75684
Phone (903) 834-0201

305 N McKinney St
Sweeny, TX 77480
Phone (979) 548-1500

11937 US Highway 271
Tyler, TX 75708
Phone (903) 877-3451

Interoperability endpoints

  • Direct secure messaging: pcritelli355100@ahs.direct-ci.com

Organizations & group practices 7

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 3

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": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1831351790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11937 US HIGHWAY 271",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757083154",
            "telephone_number": "903-877-8790",
            "fax_number": "903-877-7223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11937 US HIGHWAY 271",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757083154",
            "telephone_number": "903-877-8790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRITELLI",
        "first_name": "PAUL",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-01",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "Q6618",
            "primary": true
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": "Q6618",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.