NPIMap

Individual provider Active NPI

Kaushal Sondarwa, MD

  • Nephrology Physician
  • San Angelo, TX
National Provider Identifier
1225397250
Registry record updated Nov 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
R3220 Issued in TX
Practice address
220 E. Harris
San Angelo, TX 76903
Phone
(325) 658-1511
NPI assigned
May 11, 2012
Last updated
Nov 19, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X R3220 TX Primary

Addresses

Primary practice location

220 E. Harris
San Angelo, TX 76903

Mailing address

PO Box 22000
San Angelo, TX 76902-7200
Phone (325) 481-2291

Other identifiers 1

IdentifierTypeStateIssuer
R3220OtherTXTX LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170731003115 TX Practitioner - Nephrology 8426329020 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shannon ClinicGroup PAC ID 0840103727, 550 clinicians

Practice addresses (Care Compare)

220 E Harris Ave
San Angelo, TX 76903-5906
Phone (325) 747-1511

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.63 of 100Reported as group
Quality
78.21
Promoting interoperability
96
Improvement activities
40
Cost
67.22

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shannon Clinic CurrentSince Jul 1, 2017 Accepting new patients
Shannon Clinic CurrentSince Jul 1, 2017 Accepting new patients

Locations

120 E Beauregard Ave
San Angelo, TX 76903
Phone (915) 658-1511

220 E Harris Ave
San Angelo, TX 76903
Phone (325) 481-2000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1336694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542585600000",
    "number": "1225397250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22000",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769027200",
            "telephone_number": "325-481-2291",
            "fax_number": "325-481-2280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 E. HARRIS",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "76903",
            "telephone_number": "325-658-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONDARWA",
        "first_name": "KAUSHAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-11",
        "last_updated": "2018-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "R3220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX LICENSE",
            "identifier": "R3220",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

Verify at the official NPI Registry.