Individual provider Active NPI

Saranya Sundaram Patel, PH.D.

  • Clinical Neuropsychologist
  • Dallas, TX
National Provider Identifier
1043994155
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
39656 Issued in TX
Practice address
6080 N Central Expy # 125
Dallas, TX 75206-5202
Phone
(469) 646-6796
NPI assigned
Jun 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X
Clinical Neuropsychologist 103G00000X 39656 TX Primary

Addresses

Primary practice location

6080 N Central Expy # 125
Dallas, TX 75206-5202

Mailing address

10744 Manuel St
Frisco, TX 75035-0965
Phone (903) 267-2569

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230629004240 TX Practitioner - Clinical Psychologist 8426417098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
One RehabGroup PAC ID 7618208752, 23 clinicians

Practice addresses (Care Compare)

6080 N Central Expy
Dallas, TX 75206-5202
Phone (972) 845-7875

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39656TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
One Rehab CurrentSince Jun 15, 2023 Accepting new patients

Locations

6080 N Central Expy
#125
Dallas, TX 75206
Phone (469) 336-3613

6080 N Central Expy
Dallas, TX 75206
Phone (469) 646-0366

1761 International Pkwy
Ste 135
Richardson, TX 75081
Phone (972) 757-8684

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1686528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1043994155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10744 MANUEL ST",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750350965",
            "telephone_number": "903-267-2569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6080 N CENTRAL EXPY # 125",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752065202",
            "telephone_number": "469-646-6796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SARANYA",
        "middle_name": "SUNDARAM",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-12",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "TX",
            "license": "39656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.