Individual provider Active NPI

John Francis Eidt, M.D.

  • Vascular Surgery Physician
  • Dallas, TX
National Provider Identifier
1932115987
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
F9394 Issued in TX
Practice address
621 N Hall St Ste 100
Dallas, TX 75226-1305
Phone
(214) 821-9600
Fax
(214) 823-5290
NPI assigned
Jul 31, 2006
Last updated
Sep 1, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X R-3908 AR
Vascular Surgery Physician 2086S0129X 35233 SC
Vascular Surgery Physician 2086S0129X F9394 TX Primary

Addresses

Primary practice location

621 N Hall St Ste 100
Dallas, TX 75226-1305

Mailing address

621 N Hall St Ste 100
Dallas, TX 75226-1305
Phone (214) 821-9600

Other identifiers 1

IdentifierTypeStateIssuer
114686001MedicaidAR

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
I20150825003861 TX Practitioner - Vascular Surgery 2264447655 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
University of Texas Southwestern Medical School at Dallas, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

3500 Gaston Ave
FL 1
Dallas, TX 75246-2017
Phone (972) 817-6100

4001 Worth St
Dallas, TX 75246-1608

611 N Hall St
400 Baylor Scott and White Cardiology Consult
Dallas, TX 75226-1337
Phone (469) 800-7400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)14
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R-3908ARMDVascular Surgery Physician
F9394TXMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Aug 15, 2022 Accepting new patients
Texas Vascular Associates Vascular Surgery CurrentSince Aug 1, 2015 Accepting new patients
Healthtexas Provider Network CurrentSince Aug 15, 2022 Accepting new patients
Healthtexas Provider Network Past Accepting new patients
Greenville Health System Past Accepting new patients

Locations

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

621 N Hall St
Ste 100
Dallas, TX 75226
Phone (214) 820-0600

8865 Synergy Dr
Ste 100
McKinney, TX 75070
Phone (972) 562-1119

4716 Alliance Blvd
Ste 200
Plano, TX 75093
Phone (972) 665-9100

399 W Campbell Rd
Ste 300
Richardson, TX 75080
Phone (972) 665-9100

Interoperability endpoints

  • Direct secure messaging: jeidt457157@direct.sw.org

Organizations & group practices 5

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1932115987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 N HALL ST STE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752261305",
            "telephone_number": "214-821-9600",
            "fax_number": "214-823-5290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 N HALL ST STE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752261305",
            "telephone_number": "214-821-9600",
            "fax_number": "214-823-5290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIDT",
        "first_name": "JOHN",
        "middle_name": "FRANCIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "AR",
            "license": "R-3908",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "SC",
            "license": "35233",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TX",
            "license": "F9394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114686001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.