Individual provider Active NPI

Joseph Richard Kilianski Jr., MD

  • Obstetrics & Gynecology Physician
  • Grapevine, TX
National Provider Identifier
1912935768
Registry record updated Sep 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
H4463 Issued in TX
Practice address
1600 Lancaster Dr Ste 101
Grapevine, TX 76051-3579
Phone
(817) 251-5024
Fax
(817) 251-5135
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X H4463 TX Primary

Addresses

Primary practice location

1600 Lancaster Dr Ste 101
Grapevine, TX 76051-3579

Mailing address

P.O. Box 961205
Fort Worth, TX 76161-1205
Phone (817) 740-8450

Other identifiers 2

IdentifierTypeStateIssuer
041746104MedicaidTX
P01319803OtherTXRAILROAD MEDICARE

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
I20040209001152 TX Practitioner - Obstetrics/Gynecology 0143114405 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Texas a & M University System, HSC, College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Health Care PLLCGroup PAC ID 7214840867, 363 clinicians
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

1600 Lancaster Dr
Suite 101
Grapevine, TX 76051-3579
Phone (817) 251-5024

1650 W College St
Grapevine, TX 76051-3565
Phone (817) 388-3440

5408 Colleyville Blvd
Colleyville, TX 76034-5833
Phone (817) 498-9920

Hospital & facility affiliations

  • Baylor Scott & White Medical Center Grapevine Hospital, Grapevine, TX, CCN 450563

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H4463TXMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg Texas Holdings, P.a. Obstetrics & Gynecology CurrentSince Mar 19, 2020 Accepting new patients
Texas Health Care, P.L.L.C. CurrentSince May 1, 2017 Accepting new patients
Healthtexas Provider Network CurrentSince Jan 5, 2026 Accepting new patients
Texas Health Care, P.L.L.C. Obstetrics & Gynecology CurrentSince May 1, 2017 Accepting new patients
Healthtexas Provider Network CurrentSince Jan 5, 2026 Accepting new patients
Texas Health Care, P.L.L.C. Current Accepting new patients
North Texas Womens Health Care Associates P a Obstetrics & Gynecology Past Accepting new patients

Locations

3500 Gaston Ave
Dallas, TX 75246

2821 Lackland Rd
Ste 300
Ft Worth, TX 76116
Phone (817) 740-8400

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

1600 W College St
Ste 190
Grapevine, TX 76051
Phone (817) 305-2061

1650 W College St
Ste 1100
Grapevine, TX 76051
Phone (817) 741-2601

1600 Lancaster Dr
Ste 101
Grapevine, TX 76051
Phone (817) 251-5024

1141 Keller Pkwy
Ste A
Keller, TX 76248
Phone (817) 741-2601

6700 Buenos Aires Dr
North Richlnd Hls, TX 76180
Phone (817) 281-8245

Interoperability endpoints

  • Direct secure messaging: joseph.kilianskijr.p1@direct.thc.nextgenshare.com
  • Direct secure messaging: jkilianski456894@direct.sw.org

Organizations & group practices 8

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.

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568419200000",
    "number": "1912935768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 961205",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761611205",
            "telephone_number": "817-740-8450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 LANCASTER DR STE 101",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513579",
            "telephone_number": "817-251-5024",
            "fax_number": "817-251-5135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILIANSKI",
        "first_name": "JOSEPH",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2019-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "H4463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041746104",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01319803",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grapevine, TX

Sources for this page

Verify at the official NPI Registry.