Rupa Pachigolla MD PSC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

N0337 Issued in TX

Legal business name

RUPA PACHIGOLLA MD PSC

Practice address

2016 Fort Worth Hwy
Weatherford, TX 76086-4706

Phone

(817) 596-8637

Fax

(817) 599-3614

NPI assigned

Jun 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Rupa Pachigolla, M.D.NPI 1639165731

Title

Physician

Phone

(817) 596-8637

Specialties & licenses 1

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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

• Rupa R Pachigolla, M.D.

  • Family Medicine Physician
  • Weatherford, TX
  • NPI 1639165731
  Medicare reassignment NPD Authorized official
• Ravi V Pachigolla, M.D.

  • Otolaryngology Physician
  • Weatherford, TX
  • NPI 1396731402
  NPD (past)

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651104000000",
    "number": "1003013350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2016 FORT WORTH HWY",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760864706",
            "telephone_number": "817-596-8637",
            "fax_number": "817-599-3614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2016 FORT WORTH HWY",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760864706",
            "telephone_number": "817-596-8637",
            "fax_number": "817-599-3614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUPA PACHIGOLLA MD PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-29",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A",
        "authorized_official_last_name": "PACHIGOLLA",
        "authorized_official_first_name": "RUPA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "817-596-8637",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N0337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PIN",
            "identifier": "00Z738",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197261401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA #",
            "identifier": "45D1093868",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCRE INDV NPI #",
            "identifier": "1639165731",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "38179",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003013350",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS LICENSE",
            "identifier": "N0337",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GRP #",
            "identifier": "197259801",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64071715",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven L Ross, D.O.
• David Rowe
• Kelsey N Rowe
• Desiree Ruch
• Suzanne Bridges Rudolph, LPC-ASSOCIATE
• Michael Russell
• Jayson Rutherford, PHARMD
• Alexandra Ryan, LACMH
• Catherine Saathoff
• Malinda Sachse

• Family Medicine Physician in Weatherford, TX
• Providers in Weatherford, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.