Ricardo Chujutalli, CSA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

4924 Marsh Harrier Ave
Grand Prairie, TX 75052-3057

Phone

(972) 652-0705

Fax

(972) 752-7889

NPI assigned

Mar 12, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• 247 OBGYN Surgical Assisting Services

  dba Ricardo Chujutalli CSA

  • Surgical Physician Assistant
  • Grand Prairie, TX
  • NPI 1790179893

  Surgical Assistant

  NPD (past) Authorized official

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

{
    "created_epoch": "1236816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427328000000",
    "number": "1215178769",
    "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": "750523057",
            "telephone_number": "972-652-0705",
            "fax_number": "972-752-7889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4924 MARSH HARRIER AVE",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750523057",
            "telephone_number": "972-652-0705",
            "fax_number": "972-752-7889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUJUTALLI",
        "first_name": "RICARDO",
        "credential": "CSA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-12",
        "last_updated": "2015-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Young Cho, DDS
• Christian Medical LLC
• Christian Medical, LLC
• Christine P. Le, DDS PA (Family Dentistry of Grand Prairie)
• Christy Hafford (Community Connection Home Health)
• Mary Nnenna Chukwu, RN
• Chyma Care Services (Aaron Home Care)
• City of Grand Prairie
• Ajala Bell Clark
• Amaya Clark, MS. BCBA, LBA

• Surgical Physician Assistant in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Surgical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; 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.