Individual provider Active NPI

Praveen Ranga Srungaram, MD

  • Gastroenterology Physician
  • Dallas, TX
National Provider Identifier
1184715781
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
M4562 Issued in TX
Practice address
8200 Walnut Hill LN
Dallas, TX 75231-4402
Phone
(214) 345-5634
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M4562 TX
Gastroenterology Physician 207RG0100X M4562 TX Primary

Addresses

Primary practice location

8200 Walnut Hill LN
Dallas, TX 75231-4402

Mailing address

PO Box 845347
Dallas, TX 75284-7208
Phone (214) 345-5634

Other identifiers 2

IdentifierTypeStateIssuer
1878753-04MedicaidTX
P00958818OtherTXMEDICARE RAILROAD

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
I20070306000089 TX Practitioner - GastroenterologyPractitioner - General Practice 0941303390 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: General Practice
Education
University of Texas Medical Branch at Galveston, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

8200 Walnut Hill LN
Ut Southwestern Medical Center
Dallas, TX 75231-4402
Phone (214) 345-5634

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy72
Upper gastrointestinal (GI) endoscopy for acid reflux101

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Jun 1, 2019 Accepting new patients
Healthtexas Provider Network Internal Medicine Current Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Apr 15, 2024 Accepting new patients
Healthtexas Provider Network CurrentSince Jun 1, 2019 Accepting new patients
Healthtexas Provider Network--Dallas Diagnostic Association Internal Medicine CurrentSince Jul 27, 2010 Accepting new patients
Healthtexas-Dallas Diagnostic Association Internal Medicine CurrentSince Jul 27, 2010 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Internal Medicine CurrentSince Apr 15, 2024 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients

Locations

8200 Walnut Hill Ln
Dallas, TX 75231
Phone (214) 345-6148

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

8080 State Highway 121
Ste 240
McKinney, TX 75070
Phone (214) 644-5360

4700 Alliance Blvd
Ste 400
Plano, TX 75093
Phone (469) 814-6631

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

Organizations & group practices 8

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 2

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1184715781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752847208",
            "telephone_number": "214-345-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 WALNUT HILL LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314402",
            "telephone_number": "214-345-5634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRUNGARAM",
        "first_name": "PRAVEEN",
        "middle_name": "RANGA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M4562",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "M4562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1878753-04",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00958818",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.