Individual provider Active NPI

Babu Hosakote Subrahmanyam, MD

  • Emergency Medicine Physician
  • Jacksboro, TX
National Provider Identifier
1093997785
Registry record updated Apr 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
34839 Issued in OK
Practice address
717 Magnolia St
Jacksboro, TX 76458-1111
Phone
(940) 567-6633
NPI assigned
Dec 4, 2007
Last updated
Apr 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 34839 OK Primary
Family Medicine Physician 207Q00000X N7433 TX

Addresses

Primary practice location

717 Magnolia St
Jacksboro, TX 76458-1111

Mailing address

717 Magnolia St
Jacksboro, TX 76458-1111
Phone (940) 567-6633

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
I20111222000233 TX Practitioner - Emergency MedicinePractitioner - Family Practice 2062688005 Reassigns benefits to 4 organizations
Practice locations: Jacksboro, TX

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
99.43 of 100Reported as group
Quality
93.73
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34839OKMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Concord Medical Group PLLC Emergency Medicine CurrentSince Feb 24, 2013 Accepting new patients
Century Integrated Partners, Inc Emergency Medicine CurrentSince Mar 1, 2024 Accepting new patients
Acs Primary Care Physicians Southwest, PA Emergency Medicine CurrentSince Aug 1, 2017 Accepting new patients
Concord Medical Group of Texas PLLC Emergency Medicine CurrentSince Feb 24, 2013 Accepting new patients
Questcare Medical Services, PLLC Emergency Medicine Current Accepting new patients
Physician Services of Jacksboro PA PastSince Dec 1, 2012 Accepting new patients

Locations

5000 Hopyard Rd
Ste 100
Pleasanton, CA 94588
Phone (480) 861-4015

3500 Gaston Ave
Dallas, TX 75246

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

2600 E Pflugerville Pkwy
Ste 100
Pflugerville, TX 78660
Phone (512) 654-6100

3901 W 15th St
Plano, TX 75075
Phone (972) 519-1115

4700 Alliance Blvd
#P
Plano, TX 75093
Phone (469) 814-2000

1975 Alpha Dr
#100
Rockwall, TX 75087
Phone (214) 294-6200

713 E Anderson St
Weatherford, TX 76086
Phone (682) 582-1000

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1093997785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 MAGNOLIA ST",
            "city": "JACKSBORO",
            "state": "TX",
            "postal_code": "764581111",
            "telephone_number": "940-567-6633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 MAGNOLIA ST",
            "city": "JACKSBORO",
            "state": "TX",
            "postal_code": "764581111",
            "telephone_number": "940-567-6633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSAKOTE SUBRAHMANYAM",
        "first_name": "BABU",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-04",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "34839",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N7433",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksboro, TX

Sources for this page

Verify at the official NPI Registry.