Individual provider Active NPI

Smitha Rudraraju, M.D.

  • Rheumatology Physician
  • Plano, TX
National Provider Identifier
1104024371
Registry record updated Apr 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
N5984 Issued in TX
Practice address
4716 Alliance Blvd Ste 775
Plano, TX 75093
Phone
(469) 800-6000
Fax
(469) 800-6000
NPI assigned
Jul 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X N5984 TX Primary

Addresses

Primary practice location

4716 Alliance Blvd Ste 775
Plano, TX 75093

Mailing address

4716 Alliance Boulevard
Ste 775
Plano, TX 75093-5371
Phone (469) 800-6069

Other practice location 1

909 9th Ave
Suite 300
Fort Worth, TX 76104-3903
Phone (817) 336-7191

Other practice location 2

909 9th Ave
Suite 300
Fort Worth, TX 76104-3903
Phone (817) 336-7191

Other identifiers 3

IdentifierTypeStateIssuer
217842801MedicaidTX
217842802MedicaidTX
P00882615OtherTXRAILROAD MEDICARE

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
I20101215001126 TX Practitioner - RheumatologyPractitioner - Internal Medicine 8628160496 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Wayne State University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Arthritis and Rheumatology Institute, PLLCGroup PAC ID 0941540496, 7 clinicians

Practice addresses (Care Compare)

981 State Hwy 121
Suite 3150
Allen, TX 75013-6151
Phone (972) 798-8553

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arthritis and Rheumatology Institute, PLLC Rheumatology CurrentSince Mar 1, 2024 Accepting new patients
Medical Clinic of North Texas PLLC Past Accepting new patients

Locations

981 State Highway 121
Ste 3150
Allen, TX 75013
Phone (972) 798-5883

3550 Parkwood Blvd
Ste 405
Frisco, TX 75034
Phone (469) 287-8800

8501 Wade Blvd
Ste 820
Frisco, TX 75034

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • FHIR API: https://fhir4.healow.com/fhir/r4/BBJDCD/Endpoint/BBJDCD

Organizations & group practices 2

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": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555200000000",
    "number": "1104024371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4716 ALLIANCE BOULEVARD",
            "address_2": "STE 775",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935371",
            "telephone_number": "469-800-6069",
            "fax_number": "469-800-6061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4716 ALLIANCE BLVD STE 775",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "75093",
            "telephone_number": "469-800-6000",
            "fax_number": "469-800-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "909 9th Ave",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761043903",
            "country_code": "US",
            "telephone_number": "817-336-7191",
            "fax_number": "817-332-8076",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "909 9th Ave",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761043903",
            "country_code": "US",
            "telephone_number": "817-336-7191",
            "fax_number": "817-332-8076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUDRARAJU",
        "first_name": "SMITHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2019-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "TX",
            "license": "N5984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "217842801",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "217842802",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00882615",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.