Individual provider Active NPI

Randy Mel Naidoo, M.D.

  • Pediatrics Physician
  • Richardson, TX
National Provider Identifier
1104830033
Registry record updated Oct 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
M0506 Issued in TX
Practice address
3600 Shire Blvd
Suite 110
Richardson, TX 75082-2240
Phone
(469) 333-1543
Fax
(877) 878-9118
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2014

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 M0506 TX Primary

Addresses

Primary practice location

3600 Shire Blvd
Suite 110
Richardson, TX 75082-2240

Mailing address

1954 Novel Dr
Garland, TX 75040-1222
Phone (424) 262-4366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M0506TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shine Pediatrics and Wellness Center P.a. Pediatrics Current Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

1650 W Rosedale St
Ste 200
Ft Worth, TX 76104
Phone (817) 877-5381

3600 Shire Blvd
Ste 110
Richardson, TX 75082
Phone (469) 333-1543

Interoperability endpoints

  • Direct secure messaging: docshine@sp-tx.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413590400000",
    "number": "1104830033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1954 NOVEL DR",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750401222",
            "telephone_number": "424-262-4366",
            "fax_number": "206-339-4704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 SHIRE BLVD",
            "address_2": "SUITE 110",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750822240",
            "telephone_number": "469-333-1543",
            "fax_number": "877-878-9118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIDOO",
        "first_name": "RANDY",
        "middle_name": "MEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2014-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "M0506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.