Organization Active NPI

Sleep Medicine Institute of Texas, PA

  • Sleep Medicine (Internal Medicine) Physician
  • Tyler, TX
National Provider Identifier
1063750420
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X
Legal business name
SLEEP MEDICINE INSTITUTE OF TEXAS, PA
Practice address
3187 Paluxy Dr
Tyler, TX 75701-8303
Phone
(903) 787-7533
Fax
(903) 787-8825
NPI assigned
Jan 19, 2013
Reactivated
Jun 27, 2023
Last updated
Jun 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Authorized official

Name
Dr. Raghavendra V Ghuge, M.D., D,ABSMNPI 1891768461
Title
President
Phone
(903) 787-7533

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X
Family Nurse Practitioner 363LF0000X
Sleep Medicine (Internal Medicine) Physician 207RS0012X Primary

Addresses

Primary practice location

3187 Paluxy Dr
Tyler, TX 75701-8303

Mailing address

3187 Paluxy Dr
Tyler, TX 75701-8303
Phone (903) 787-7533

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20130621000218 TX Part B Supplier - Clinic/Group Practice 9133368236 Receives reassigned benefits from 1 practitioner
Practice locations: Tyler, TX
O20210122001655 TX DME Supplier - Physician - Unknown Physician SpecialtyDME Supplier - Multi-Specialty - Physician 9133368236 Practice locations: Tyler, TX

National Provider Directory

National Provider Directory

Locations

115 W 5th St
Ste 200
Tyler, TX 75701
Phone (903) 787-7533

3187 Paluxy Dr
Tyler, TX 75701
Phone (903) 787-7533

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JGDHDD

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1358553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687824000000",
    "number": "1063750420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3187 PALUXY DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757018303",
            "telephone_number": "903-787-7533",
            "fax_number": "903-787-8825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3187 PALUXY DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757018303",
            "telephone_number": "903-787-7533",
            "fax_number": "903-787-8825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLEEP MEDICINE INSTITUTE OF TEXAS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-19",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "deactivation_date": "2023-04-12",
        "reactivation_date": "2023-06-27",
        "status": "A",
        "authorized_official_last_name": "GHUGE",
        "authorized_official_first_name": "RAGHAVENDRA",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-787-7533",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., D,ABSM"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 27, 2023; 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.