NPIMap

Organization Active NPI

Claire Tibiletti MD PA

  • Interventional Pain Medicine Physician
  • Tyler, TX
National Provider Identifier
1992922033
Registry record updated Jan 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
G3856 Issued in TX
Legal business name
CLAIRE TIBILETTI MD PA
Practice address
1814 Roseland Blvd
Suite 300
Tyler, TX 75701-4234
Phone
(903) 597-2508
Fax
(903) 535-2914
NPI assigned
Apr 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2011

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

Authorized official

Name
Francene Bell, R.N. CMOM
Title
Office MGR.
Phone
(903) 597-2508

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X G3856 TX Primary

Addresses

Primary practice location

1814 Roseland Blvd
Suite 300
Tyler, TX 75701-4234

Mailing address

1814 Roseland Blvd
Suite 300
Tyler, TX 75701-4234
Phone (903) 597-2508

Other identifiers 4

IdentifierTypeStateIssuer
DA5545OtherTXRAILROAD MEDICARE GROUP
P00063083OtherTXRAILROAD MEDICARE INDIVIDUAL
0037KVOtherTXBLUE CROSS BLUE SHIELD
162224301MedicaidTX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295308800000",
    "number": "1992922033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1814 ROSELAND BLVD",
            "address_2": "SUITE 300",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757014234",
            "telephone_number": "903-597-2508",
            "fax_number": "903-535-2914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 ROSELAND BLVD",
            "address_2": "SUITE 300",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757014234",
            "telephone_number": "903-597-2508",
            "fax_number": "903-535-2914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAIRE TIBILETTI MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2011-01-18",
        "status": "A",
        "authorized_official_last_name": "BELL",
        "authorized_official_first_name": "FRANCENE",
        "authorized_official_title_or_position": "OFFICE MGR.",
        "authorized_official_telephone_number": "903-597-2508",
        "authorized_official_credential": "R.N. CMOM"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "TX",
            "license": "G3856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "DA5545",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE INDIVIDUAL",
            "identifier": "P00063083",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0037KV",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162224301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.