Organization Active NPI

Prosper Family Medicine, P.a.

  • Family Medicine Physician
  • Prosper, TX
National Provider Identifier
1083737688
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PROSPER FAMILY MEDICINE, P.A.
Practice address
270 S Preston Rd Ste 30
Prosper, TX 75078-9802
Phone
(972) 346-2279
Fax
(972) 346-3766
NPI assigned
Apr 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Authorized official

Name
Dr. Manju K Pandey, M.D.NPI 1396070348
Title
Physician Owner
Phone
(214) 412-5845

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

270 S Preston Rd Ste 30
Prosper, TX 75078-9802

Mailing address

PO Box 3278
McKinney, TX 75070-8185
Phone (972) 346-2279

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070629000280 TX Part B Supplier - Clinic/Group Practice 3779682877 Receives reassigned benefits from 4 practitioners
Practice locations: Prosper, TX

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1060173Prosper Family Medicine270 N Preston Road Suite 30, Prosper, TX 75078Provider-performed microscopyOct 16, 2026

National Provider Directory

National Provider Directory

Locations

270 S Preston Rd
Ste 30
Prosper, TX 75078
Phone (972) 346-2279

Practitioners & affiliated clinicians

Practitioners 5

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": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1083737688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3278",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750708185",
            "telephone_number": "972-346-2279",
            "fax_number": "972-346-3766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 S PRESTON RD STE 30",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750789802",
            "telephone_number": "972-346-2279",
            "fax_number": "972-346-3766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPER FAMILY MEDICINE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "PANDEY",
        "authorized_official_first_name": "MANJU",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "214-412-5845",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prosper, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.