Individual provider Active NPI

Soumya Lakshmi Polavarapu, DO

  • Sports Medicine (Family Medicine) Physician
  • Austin, TX
National Provider Identifier
1093403438
Registry record updated Jun 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
823271 Issued in TX
Practice address
2901 Montopolis Dr
Austin, TX 78741-6411
Phone
(512) 978-9901
NPI assigned
Apr 25, 2023
Last updated
Jun 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 823271 TX Primary

Addresses

Primary practice location

2901 Montopolis Dr
Austin, TX 78741-6411

Mailing address

1501 Red River St FL 2
Austin, TX 78712-1845
Phone (512) 495-5555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20230630000522 MN Order and Referring Only - Family PracticePractitioner - Family PracticePractitioner - Sports Medicine 8022477595

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33867MNMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1682380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782432000000",
    "number": "1093403438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 RED RIVER ST FL 2",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787121845",
            "telephone_number": "512-495-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 MONTOPOLIS DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787416411",
            "telephone_number": "512-978-9901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLAVARAPU",
        "first_name": "SOUMYA",
        "middle_name": "LAKSHMI",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-25",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "TX",
            "license": "823271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.