NPIMap

Individual provider Active NPI

Supratik Kumar Moulik, MD

  • Diagnostic Radiology Physician
  • Missouri City, TX
National Provider Identifier
1245454693
Registry record updated May 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD438343 Issued in PA
Practice address
1706 Pebblestone CT
Missouri City, TX 77459-1617
Phone
(512) 680-7346
NPI assigned
Apr 13, 2007
Last updated
May 15, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD438343 PA Primary

Addresses

Primary practice location

1706 Pebblestone CT
Missouri City, TX 77459-1617

Mailing address

1706 Pebblestone CT
Missouri City, TX 77459-1617
Phone (512) 680-7346

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OK2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20111020000132 TX Practitioner - Diagnostic Radiology 1456532001 Reassigns benefits to 9 organizations
I20150813009493 OK Practitioner - Diagnostic Radiology 1456532001 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Texas Southwestern Medical School at Dallas, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Singleton Associates PAGroup PAC ID 6305731118, 814 clinicians
Eagle Partners, PLLCGroup PAC ID 9032205752, 170 clinicians

Practice addresses (Care Compare)

1106 Alston Ave
Suite 175
Fort Worth, TX 76104-4644
Phone (713) 461-3573

3100 SW 89TH St
Community Hospital South
Oklahoma City, OK 73159-7900
Phone (405) 602-8100

921 Gessner Rd
Houston, TX 77024-2501
Phone (405) 286-4114

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sonoran Radiology LTD Diagnostic Radiology CurrentSince Jun 28, 2020 Accepting new patients
Coastal Radiology Associates, PLLC Diagnostic Radiology CurrentSince Jun 14, 2017 Accepting new patients
Screening for Life LLC CurrentSince Feb 1, 2014 Accepting new patients
Community Hospital LLC Diagnostic Radiology CurrentSince Jul 11, 2015 Accepting new patients
Greensboro Radiology, PA Diagnostic Radiology CurrentSince Sep 1, 2020 Accepting new patients
Synergy Radiology Associates PLLC CurrentSince Aug 23, 2021 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients
Provider Services of Texas LLC Diagnostic Radiology Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Great Plains Radiology LLC Diagnostic Radiology Past Accepting new patients
Premier Radiology Associates, Inc. Diagnostic Radiology Past Accepting new patients
Radiology Associates of Canton, Inc. Diagnostic Radiology Past Accepting new patients
Consultants in Radiology PA Diagnostic Radiology Past Accepting new patients

Locations (25 of 58)

3648 W Anthem Way
Ste A100
Anthem, AZ 85086
Phone (623) 434-6444

2050 W Southern Ave
Apache Junction, AZ 85120
Phone (480) 237-3200

1800 E Florence Blvd
Casa Grande, AZ 85122
Phone (520) 381-6285

1900 N Higley Rd
Gilbert, AZ 85234
Phone (480) 543-2000

3645 S Rome St
Ste 101
Gilbert, AZ 85297

5555 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 588-5555

6220 W Bell Rd
Ste 110
Glendale, AZ 85308
Phone (602) 547-7230

17900 N Porter Rd
Maricopa, AZ 85138
Phone (520) 233-2500

1052 E McKellips Rd
Mesa, AZ 85203
Phone (480) 425-5080

1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000

6644 E Baywood Ave
Mesa, AZ 85206
Phone (480) 321-2000

6750 E Baywood Ave
Mesa, AZ 85206
Phone (480) 854-5000

10575 N Tatum Blvd
Ste C128
Paradise Vly, AZ 85253
Phone (480) 998-1490

807 S Ponderosa St
Payson, AZ 85541
Phone (520) 474-3222

10230 W Happy Valley Pkwy
Ste 100
Peoria, AZ 85383
Phone (623) 266-4699

13640 N Plaza del Rio Blvd
Peoria, AZ 85381
Phone (623) 876-3800

9165 W Thunderbird Rd
Peoria, AZ 85381
Phone (623) 285-1120

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

18404 N Tatum Blvd
Ste 103
Phoenix, AZ 85032
Phone (602) 485-7490

19636 N 27th Ave
Ste LL1
Phoenix, AZ 85027
Phone (602) 485-7482

19829 N 27th Ave
Phoenix, AZ 85027
Phone (602) 879-5720

20940 N Tatum Blvd
Ste 390
Phoenix, AZ 85050
Phone (480) 407-0060

2222 E Highland Ave
Ste 120
Phoenix, AZ 85016
Phone (602) 977-1177

250 E Dunlap Ave
Phoenix, AZ 85020
Phone (480) 331-6721

26224 N Tatum Blvd
Phoenix, AZ 85050
Phone (480) 663-9632

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: smoulik@direct.uspi.com

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305417600000",
    "number": "1245454693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 PEBBLESTONE CT",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774591617",
            "telephone_number": "512-680-7346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 PEBBLESTONE CT",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774591617",
            "telephone_number": "512-680-7346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULIK",
        "first_name": "SUPRATIK",
        "middle_name": "KUMAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2011-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD438343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missouri City, TX

Sources for this page

Verify at the official NPI Registry.