Summit Gastroenterology PLLC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

P1484 Issued in TX

Legal business name

SUMMIT GASTROENTEROLOGY PLLC

Practice address

309 Regency Pkwy Ste 101
Mansfield, TX 76063-5165

Phone

(682) 400-2153

Fax

(972) 572-2228

NPI assigned

Oct 24, 2013

Organization subpart

No

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

Authorized official

Name

Sunitha Pudhota, MDNPI 1952362980

Title

Owner

Phone

(682) 400-2153

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14953/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sunitha Gudapati Pudhota, MD

  • Gastroenterology Physician
  • Mansfield, TX
  • NPI 1952362980
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1382572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559088000000",
    "number": "1114355385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 REGENCY PKWY STE 101",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760635165",
            "telephone_number": "682-400-2153",
            "fax_number": "972-572-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 REGENCY PKWY STE 101",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760635165",
            "telephone_number": "682-400-2153",
            "fax_number": "972-572-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT GASTROENTEROLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-24",
        "last_updated": "2019-05-29",
        "status": "A",
        "authorized_official_last_name": "PUDHOTA",
        "authorized_official_first_name": "SUNITHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "682-400-2153",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "P1484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saba Suhail, DO
• Alana Joelle Sullivan
• Deborah C. Sullivan, D.D.S.
• Sumerians Homecare LLC
• Katherine Summerlin, FNP-C
• Sundep LLC
• Sunflower Orthodontics PLLC
• Bradley Joe Sutton
• Sophie Blaire Swain
• Joya K Sykes, DO

• Gastroenterology Physician in Mansfield, TX
• Providers in Mansfield, TX by specialty
• Gastroenterology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.