Individual provider Active NPI

Prabhjot Randev, MBBS

  • Pediatrics Physician
  • Windcrest, TX
National Provider Identifier
1275969982
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
R0105 Issued in TX
Practice address
5542 Walzem Rd
Windcrest, TX 78218-2103
Phone
(210) 922-7000
Fax
(210) 637-2499
NPI assigned
Sep 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X R0105 TX Primary

Addresses

Primary practice location

5542 Walzem Rd
Windcrest, TX 78218-2103

Mailing address

3750 Commercial Ave
San Antonio, TX 78221-3117
Phone (210) 922-7000

Other identifiers 1

IdentifierTypeStateIssuer
1275969982OtherTXNPI

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
I20161115002609 TX Practitioner - Pediatric Medicine 2860771888 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
El Centro del Barrio, Inc. CurrentSince Nov 1, 2016 Accepting new patients
El Centro del Barrio, Inc. CurrentSince Nov 1, 2016 Accepting new patients
El Centro del Barrio, Inc. Past Accepting new patients

Locations

6315 S Zarzamora St
San Antonio, TX 78211
Phone (210) 924-9254

3750 Commercial Ave
San Antonio, TX 78221
Phone (210) 334-3700

5542 Walzem Rd
Windcrest, TX 78218
Phone (210) 637-2450

Interoperability endpoints

  • Direct secure messaging: prabhjot.randev.p1@direct.centromed.nextgenshare.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1380067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1275969982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 COMMERCIAL AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782213117",
            "telephone_number": "210-922-7000",
            "fax_number": "210-637-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5542 WALZEM RD",
            "city": "WINDCREST",
            "state": "TX",
            "postal_code": "782182103",
            "telephone_number": "210-922-7000",
            "fax_number": "210-637-2499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDEV",
        "first_name": "PRABHJOT",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-25",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "R0105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1275969982",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Windcrest, TX

Sources for this page

Verify at the official NPI Registry.