Individual provider Active NPI

Sangeetha Pabolu, M.D.

  • Rheumatology Physician
  • Round Rock, TX
National Provider Identifier
1093970022
Registry record updated Sep 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
T3156 Issued in TX
Practice address
425 University Blvd
Round Rock, TX 78665-1047
Phone
(512) 509-0200
Fax
(512) 509-0285
NPI assigned
Jul 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 25MA10341600 NJ
Rheumatology Physician 207RR0500X T3156 TX Primary

Addresses

Primary practice location

425 University Blvd
Round Rock, TX 78665-1047

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (254) 724-2111

Other identifiers 1

IdentifierTypeStateIssuer
1532497MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address spabolu860751@direct.sw.org Direct

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
I20210827001350 TX Practitioner - Rheumatology 9638318207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

1300 E Polk St
Baylor Scott and White Clinic Burnet
Burnet, TX 78611-2136
Phone (512) 715-6400

1605 S 31St St
Baylor Scott and White Center for Dia
Temple, TX 76508-0001
Phone (254) 215-0100

2401 S 31 St
Temple, TX 76508-0001
Phone (254) 724-2459

2401 S 31St St BLDG
35 Baylor Scott and White Roney Bone and
Temple, TX 76508-0001
Phone (254) 724-2663

425 University Blvd
Round Rock, TX 78665-1053
Phone (512) 509-0200

7451 W State Hwy 29
Baylor Scott and White Clinic Georg
Georgetown, TX 78628-6849
Phone (512) 509-8700

810 W U Ave
Temple, TX 76508-0001
Phone (254) 724-2585

9800 N Lake Creek Pkwy
200 Baylor Scott and White Clinic Austi
Austin, TX 78717-5947
Phone (512) 336-3400

Hospital & facility affiliations

  • Baylor Scott & White Medical Center - Round Rock Hospital, Round Rock, TX, CCN 670034
  • Baylor Scott & White Medical Center - Marble Falls Hospital, Marble Falls, TX, CCN 670108
  • Baylor Scott & White Medical Center -Taylor Hospital, Taylor, TX, CCN 451374
  • Baylor Scott & White Medical Center Pflugerville Hospital, Pflugerville, TX, CCN 670128
  • Baylor Scott & White Institute for Rehabilitation Inpatient rehabilitation facility, Lakeway, TX, CCN 673058

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic CurrentSince Aug 19, 2021 Accepting new patients
Scott & White Clinic CurrentSince Aug 19, 2021 Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients

Locations

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

425 University Blvd
Round Rock, TX 78665
Phone (512) 509-0100

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

2401 S 31st St
#200
Temple, TX 76508
Phone (254) 215-0100

Interoperability endpoints

  • Direct secure messaging: spabolu860751@direct.sw.org

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1216339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1093970022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 UNIVERSITY BLVD",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651047",
            "telephone_number": "512-509-0200",
            "fax_number": "512-509-0285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PABOLU",
        "first_name": "SANGEETHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-18",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NJ",
            "license": "25MA10341600",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "TX",
            "license": "T3156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1532497",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spabolu860751@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "425 University Blvd",
            "city": "Round Rock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786651047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

Verify at the official NPI Registry.