Individual provider Active NPI

Ricardo Chujutalli, MD

  • Family Medicine Physician
  • Mansfield, TX
National Provider Identifier
1154069466
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
V9870 Issued in TX
Practice address
1670 E Broad St Ste 110
Mansfield, TX 76063-1862
Phone
(682) 341-7510
NPI assigned
May 25, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X V9870 TX Primary

Addresses

Primary practice location

1670 E Broad St Ste 110
Mansfield, TX 76063-1862

Mailing address

4924 Marsh Harrier Ave.
Grand Prairie, TX 75052

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
I20250723000532 TX Practitioner - Family Practice 8022524347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loma Linda University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Huguley Medical Associates, IncGroup PAC ID 2668562471, 50 clinicians

Practice addresses (Care Compare)

1670 E Broad St
Suite 110
Mansfield, TX 76063-1862
Phone (682) 341-7510

Hospital & facility affiliations

  • Texas Health Hospital Mansfield Hospital, Mansfield, TX, CCN 670309
  • Texas Health Huguley Hospital Fort Worth South Hospital, Fort Worth, TX, CCN 450677

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Huguley Medical Associates CurrentSince Aug 11, 2025 Accepting new patients
Texas Health Physicians Group Family Medicine PastSince Jul 22, 2025 Accepting new patients

Locations

11801 South Fwy
Burleson, TX 76028
Phone (817) 551-2738

11797 South Fwy
Ste 242
Burleson, TX 76028
Phone (817) 568-1981

1670 E Broad St
Ste 110
Mansfield, TX 76063
Phone (682) 341-7510

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1653436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1154069466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4924 MARSH HARRIER AVE.",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "75052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 E BROAD ST STE 110",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760631862",
            "telephone_number": "682-341-7510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUJUTALLI",
        "first_name": "RICARDO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-25",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "V9870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

Verify at the official NPI Registry.