Individual provider Active NPI

Sujal Rangwalla, D.O.

  • Pediatric Gastroenterology Physician
  • Austin, TX
National Provider Identifier
1144354440
Registry record updated Jan 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
N3263 Issued in TX
Practice address
1301 Barbara Jordan Blvd Ste 200
Austin, TX 78723-3078
Phone
(512) 628-1810
Fax
(512) 628-1811
NPI assigned
Mar 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X N3263 TX
Pediatric Gastroenterology Physician 2080P0206X N3263 TX Primary

Addresses

Primary practice location

1301 Barbara Jordan Blvd Ste 200
Austin, TX 78723-3078

Mailing address

1301 Barbara Jordan Blvd Ste 200
Austin, TX 78723-3078
Phone (512) 628-1810

Other identifiers 1

IdentifierTypeStateIssuer
204336601MedicaidTX

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
I20090729000197 TX Practitioner - Pediatric MedicinePractitioner - Gastroenterology 3375696024 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N3263TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dell Children'S Medical Group CurrentSince Sep 28, 2014 Accepting new patients
Dell Children'S Medical Group Pediatrics CurrentSince Sep 28, 2014 Accepting new patients

Locations

1301 Barbara Jordan Blvd
Ste 200
Austin, TX 78723
Phone (512) 628-1800

1000 Hesters Crossing Rd
Round Rock, TX 78681
Phone (512) 628-1800

Interoperability endpoints

  • Direct secure messaging: sujal.rangwalla.1@8363.direct.athenahealth.com

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": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326153600000",
    "number": "1144354440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 BARBARA JORDAN BLVD STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233078",
            "telephone_number": "512-628-1810",
            "fax_number": "512-628-1811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 BARBARA JORDAN BLVD STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233078",
            "telephone_number": "512-628-1810",
            "fax_number": "512-628-1811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANGWALLA",
        "first_name": "SUJAL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2012-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "N3263",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "TX",
            "license": "N3263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204336601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.