Individual provider Active NPI

Paul W Pitts, MD

  • Pediatrics Physician
  • Tyler, TX
National Provider Identifier
1871568535
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
H3412 Issued in TX
Practice address
800 E Dawson St
Tyler, TX 75701-2036
Phone
(903) 606-4129
Fax
(903) 606-1201
NPI assigned
Feb 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X H3412 TX Primary

Addresses

Primary practice location

800 E Dawson St
Tyler, TX 75701-2036

Mailing address

PO Box 846098
Dallas, TX 75284-6098
Phone (903) 324-6450

Other practice location 1

305 W Rusk
Tyler, TX 75701
Phone (903) 592-7304

Other identifiers 4

IdentifierTypeStateIssuer
130556709MedicaidTX
130556708MedicaidTX
130556707MedicaidTX
1N6099OtherTXMEDICARE

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
I20100322000882 TX Practitioner - HospitalistPractitioner - Pediatric Medicine 4385779800 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas Pediatrics CurrentSince Jan 4, 2010 Accepting new patients
Tyler Family Circle of Care CurrentSince Feb 12, 2024 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jan 4, 2010 Accepting new patients
Tyler Family Circle of Care PastSince Jan 19, 2025 Accepting new patients

Locations

3203 S Main St
Lindale, TX 75771
Phone (903) 266-4000

305 W Rusk St
Tyler, TX 75701
Phone (903) 592-7304

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

523 S Fannin Ave
Tyler, TX 75702

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

214 E Houston St
Tyler, TX 75702
Phone (903) 593-1892

2990 N Broadway Ave
Tyler, TX 75702
Phone (903) 245-1984

Interoperability endpoints

  • Direct secure messaging: ppitts7038@christushealth.direct-ci.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1871568535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 846098",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752846098",
            "telephone_number": "903-324-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E DAWSON ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012036",
            "telephone_number": "903-606-4129",
            "fax_number": "903-606-1201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 W Rusk",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "75701",
            "country_code": "US",
            "telephone_number": "903-592-7304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PITTS",
        "first_name": "PAUL",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "H3412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130556709",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130556708",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130556707",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1N6099",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.