Individual provider Active NPI

Rabin Kheradpour, M.D.

  • Internal Medicine Physician
  • Austin, TX
National Provider Identifier
1093718462
Registry record updated Dec 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
P4661 Issued in TX
Practice address
2529 S 1St St
Austin, TX 78704-5466
Phone
(512) 978-9500
Fax
(512) 901-9708
NPI assigned
May 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A63649 CA
Internal Medicine Physician 207R00000X P4661 TX Primary

Addresses

Primary practice location

2529 S 1St St
Austin, TX 78704-5466

Mailing address

2115 Kramer LN
Suite 100
Austin, TX 78758-4013
Phone (512) 978-9000

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
I20170110001875 TX Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 8921047770

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1993
Medicare assignment
May accept Medicare assignment
Group practices
Central Texas Community Health CentersGroup PAC ID 5395802151, shared by 33 NPIs, 165 clinicians

Practice addresses (Care Compare)

2529 S 1St St
Austin, TX 78704-5466
Phone (512) 978-9865

2901 Montopolis Dr
Austin, TX 78741-6411
Phone (512) 978-9955

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A63649CAMDInternal Medicine Physician
P4661TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Texas Community Health Centers Past Accepting new patients
Indiana University Health Ball Memorial Hospital, Inc. Past Accepting new patients
Crown City Medical Group, Inc. Past Accepting new patients
Altamed Health Services Corporation Past Accepting new patients

Organizations & group practices 4

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": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480550400000",
    "number": "1093718462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 KRAMER LN",
            "address_2": "SUITE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787584013",
            "telephone_number": "512-978-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2529 S 1ST ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787045466",
            "telephone_number": "512-978-9500",
            "fax_number": "512-901-9708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHERADPOUR",
        "first_name": "RABIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2016-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A63649",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "P4661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.