Organization Active NPI

Sunil Reddy Cheruku, MD, PA

  • Internal Medicine Physician
  • Austin, TX
National Provider Identifier
1013063817
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SUNIL REDDY CHERUKU, MD, PA
Practice address
900 E 30TH St Ste 109
Austin, TX 78705-3323
Phone
(512) 544-5555
Fax
(512) 544-4143
NPI assigned
Jan 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Authorized official

Name
Dr. Sunil Reddy Cheruku, M.D.NPI 1235173345
Title
President
Phone
(512) 750-1535

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

900 E 30TH St Ste 109
Austin, TX 78705-3323

Mailing address

1918 Leander Rd
Georgetown, TX 78628-8835
Phone (737) 808-4561

Other practice location 1

12221 N Mopac Expy
Austin, TX 78758-2401
Phone (512) 901-1174

Other identifiers 1

IdentifierTypeStateIssuer
1466203MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050505000612 TX Part B Supplier - Clinic/Group Practice 9830139195 Receives reassigned benefits from 4 practitioners
Practice locations: Austin, TX; Georgetown, TX

National Provider Directory

National Provider Directory

Locations

305 E Huntland Dr
Austin, TX 78752
Phone (512) 474-5700

900 E 30th St
Ste 109
Austin, TX 78705
Phone (512) 404-8145

1918 Leander Rd
Georgetown, TX 78628
Phone (512) 275-1810

Practitioners & affiliated clinicians

Practitioners 7

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": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660089600000",
    "number": "1013063817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1918 LEANDER RD",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786288835",
            "telephone_number": "737-808-4561",
            "fax_number": "877-260-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E 30TH ST STE 109",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787053323",
            "telephone_number": "512-544-5555",
            "fax_number": "512-544-4143"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12221 N Mopac Expy",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787582401",
            "country_code": "US",
            "telephone_number": "512-901-1174",
            "fax_number": "512-901-1750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUNIL REDDY CHERUKU, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A",
        "authorized_official_last_name": "CHERUKU",
        "authorized_official_first_name": "SUNIL",
        "authorized_official_middle_name": "REDDY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-750-1535",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1466203",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.