Individual provider Active NPI

Shanmuga Pujitha Jonnalagadda, M.D.,

  • Developmental - Behavioral Pediatrics Physician
  • Dallas, TX
National Provider Identifier
1053708677
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
T4648 Issued in TX
Practice address
2222 Welborn St
Dallas, TX 75219-3924
Phone
(214) 559-5000
Fax
(214) 443-7309
NPI assigned
Apr 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X T4648 TX
Developmental - Behavioral Pediatrics Physician 2080P0006X DR.0061005 CO
Developmental - Behavioral Pediatrics Physician 2080P0006X T4648 TX Primary

Addresses

Primary practice location

2222 Welborn St
Dallas, TX 75219-3924

Mailing address

2222 Welborn St
Dallas, TX 75219-3924
Phone (214) 559-5000

Other practice location 1

13123 E 16th Ave
Aurora, CO 80045-7106
Phone (720) 777-1234

Other practice location 2

5430 Fredericksburg Rd Ste 508
San Antonio, TX 78229-3561
Phone (210) 614-5539

Other practice location 3

3800 Gaylord Pkwy Ste 850
Frisco, TX 75034-0248
Phone (469) 857-2222

Other practice location 4

5700 Dallas Pkwy
Frisco, TX 75034-9580
Phone (469) 515-7100

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
I20220314001614 TX Practitioner - Pediatric Medicine 5991136269 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0061005COMDDevelopmental - Behavioral Pediatrics Physician
T4648TXMDDevelopmental - Behavioral Pediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Magella Medical Associates Billing, Inc. CurrentSince Jan 1, 2022 Accepting new patients
Texas Scottish Rite Hospital for Crippled Children Developmental - Behavioral Pediatrics CurrentSince Nov 21, 2024 Accepting new patients

Locations

4900 Mueller Blvd
Austin, TX 78723
Phone (512) 324-0165

2222 Welborn St
Dallas, TX 75219
Phone (214) 559-5000

5700 Dallas Pkwy
Frisco, TX 75034
Phone (469) 515-7100

3800 Gaylord Pkwy
Ste 850
Frisco, TX 75034
Phone (469) 857-2222

815 Market St
Galveston, TX 77550
Phone (409) 770-6600

11777 FM 1960 Rd W
Houston, TX 77065
Phone (832) 828-3501

3901 W 15th St
Plano, TX 75075
Phone (972) 519-1115

111 Dallas St
San Antonio, TX 78205
Phone (210) 297-7000

5430 Fredericksburg Rd
Ste 508
San Antonio, TX 78229
Phone (210) 541-8281

421 E State Highway 114
Southlake, TX 76092
Phone (817) 865-4400

Organizations & group practices 2

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": "1429574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1053708677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 WELBORN ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752193924",
            "telephone_number": "214-559-5000",
            "fax_number": "214-443-7309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 WELBORN ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752193924",
            "telephone_number": "214-559-5000",
            "fax_number": "214-443-7309"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13123 E 16th Ave",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800457106",
            "country_code": "US",
            "telephone_number": "720-777-1234",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5430 Fredericksburg Rd Ste 508",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782293561",
            "country_code": "US",
            "telephone_number": "210-614-5539",
            "fax_number": "210-614-5548",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3800 Gaylord Pkwy Ste 850",
            "address_purpose": "LOCATION",
            "city": "Frisco",
            "state": "TX",
            "postal_code": "750340248",
            "country_code": "US",
            "telephone_number": "469-857-2222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5700 Dallas Pkwy",
            "address_purpose": "LOCATION",
            "city": "Frisco",
            "state": "TX",
            "postal_code": "750349580",
            "country_code": "US",
            "telephone_number": "469-515-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONNALAGADDA",
        "first_name": "SHANMUGA",
        "middle_name": "PUJITHA",
        "name_prefix": "Dr.",
        "credential": "M.D.,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-21",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "T4648",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "CO",
            "license": "DR.0061005",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "TX",
            "license": "T4648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.