Individual provider Active NPI

Michael Gillespie, M.D.

  • Psychiatry Physician
  • Beaumont, TX
National Provider Identifier
1912317264
Registry record updated Jun 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
R0236 Issued in TX
Practice address
3250 Fannin St
Beaumont, TX 77701
Phone
(409) 212-7000
NPI assigned
May 7, 2014
Last updated
Jun 2, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X R0236 TX Primary

Addresses

Primary practice location

3250 Fannin St
Beaumont, TX 77701

Mailing address

3250 Fannin St
Beaumont, TX 77701-3903
Phone (409) 212-7000

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
I20180928001494 TX Practitioner - Psychiatry 1850679473 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Texas Medical Branch at Galveston, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Physician NetworkGroup PAC ID 0547333890, 121 clinicians

Practice addresses (Care Compare)

3250 Fannin St
Beaumont, TX 77701-3903
Phone (409) 212-7000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Physician Network CurrentSince Jun 1, 2018 Accepting new patients
Baptist Hospitals of Southeast Texas Past Accepting new patients

Locations

3070 College St
Ste 120
Beaumont, TX 77701
Phone (409) 835-2300

3080 College St
Beaumont, TX 77701
Phone (409) 212-5000

3250 Fannin St
Beaumont, TX 77701
Phone (409) 212-7000

3555 Stagg Dr
Beaumont, TX 77701
Phone (409) 212-5922

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

Hospital & facility affiliations 1

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": "1399420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527897600000",
    "number": "1912317264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3250 FANNIN ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777013903",
            "telephone_number": "409-212-7000",
            "fax_number": "409-212-5265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 FANNIN ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "77701",
            "telephone_number": "409-212-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLESPIE",
        "first_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-07",
        "last_updated": "2018-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "R0236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.