Active NPI
Rabin Kheradpour, M.D.
- Internal Medicine Physician
- Austin, TX
National Provider Identifier
1093718462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- P4661
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170110001875 | TX | Order and Referring Only - 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 Centers
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
| License | State | Type | Specialty |
|---|---|---|---|
| A63649 | CA | MD | Internal Medicine Physician |
| P4661 | TX | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New 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.
-
dba CommUnityCare--Southeast Health & Wellness Center
- Federally Qualified Health Center (FQHC)
- Austin, TX
- NPI 1861420382
-
dba AltaMed Pharmacy Huntington Beach
- Community/Retail Pharmacy
- Huntington Beach, CA
- NPI 1306726419
-
- Family Medicine Physician
- Pasadena, CA
- NPI 1073512836
-
- General Acute Care Hospital
- Muncie, IN
- NPI 1225195340
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.