Individual provider Active NPI

Yogesh Jeshankar Pandya, MD

  • Pediatrics Physician
  • Lubbock, TX
National Provider Identifier
1093779167
Registry record updated Nov 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G1741 Issued in TX
Practice address
4102 24TH St
Suite 505
Lubbock, TX 79410-1806
Phone
(806) 725-8240
Fax
(806) 723-7703
NPI assigned
Apr 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X G1741 TX Primary

Addresses

Primary practice location

4102 24TH St
Suite 505
Lubbock, TX 79410-1806

Mailing address

3420 22ND Place
Lubbock, TX 79410
Phone (806) 725-5844

Other identifiers 1

IdentifierTypeStateIssuer
133081308MedicaidTX

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
I20110223000186 TX Practitioner - Pediatric Medicine 4688855794 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group Pediatrics CurrentSince Oct 11, 2010 Accepting new patients
Covenant Medical Group CurrentSince Oct 11, 2010 Accepting new patients
Methodist Children'S Hospital Past Accepting new patients

Locations

4102 24th St
Ste 505
Lubbock, TX 79410
Phone (806) 725-7275

4102 24th St
Ste 301
Lubbock, TX 79410
Phone (806) 725-7980

5202 82nd St
Lubbock, TX 79424
Phone (806) 701-5265

3420 22nd Pl
Lubbock, TX 79410
Phone (806) 725-1800

2215 Nashville Ave
Lubbock, TX 79410
Phone (806) 725-5228

5009 College Ave
Snyder, TX 79549
Phone (915) 573-1300

Interoperability endpoints

  • Direct secure messaging: yogesh.pandya@direct.myteamcare.com

Organizations & group practices 3

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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321833600000",
    "number": "1093779167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 22ND PLACE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "79410",
            "telephone_number": "806-725-5844",
            "fax_number": "806-723-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 24TH ST",
            "address_2": "SUITE 505",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101806",
            "telephone_number": "806-725-8240",
            "fax_number": "806-723-7703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANDYA",
        "first_name": "YOGESH",
        "middle_name": "JESHANKAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2011-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "G1741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133081308",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.