Ravi Pachigolla MD PSC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

K4763 Issued in TX

Legal business name

RAVI PACHIGOLLA MD PSC

Practice address

2016 Fort Worth Hwy
Weatherford, TX 76086-4706

Phone

(817) 596-8637

Fax

(817) 599-3614

NPI assigned

Jun 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Ravi V Pachigolla, M.D.NPI 1396731402

Title

Physician

Phone

(817) 596-8637

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• Ravi Pachigolla MD PSC Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ravi V Pachigolla, M.D.

  • Otolaryngology Physician
  • Weatherford, TX
  • NPI 1396731402
  Medicare reassignment NPD Authorized official
• Rupa R Pachigolla, M.D.

  • Family Medicine Physician
  • Weatherford, TX
  • NPI 1639165731
  NPD

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651104000000",
    "number": "1295932549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2016 FORT WORTH HWY",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760864706",
            "telephone_number": "817-596-8637",
            "fax_number": "817-599-3614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2016 FORT WORTH HWY",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760864706",
            "telephone_number": "817-596-8637",
            "fax_number": "817-599-3614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAVI PACHIGOLLA MD PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-29",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A",
        "authorized_official_last_name": "PACHIGOLLA",
        "authorized_official_first_name": "RAVI",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "817-596-8637",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "K4763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PIN",
            "identifier": "00Z738",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI #",
            "identifier": "1295932549",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64071855",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GRP PIN#",
            "identifier": "198437901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "38283",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS LICENSE",
            "identifier": "K4763",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "198438701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ravi Pachigolla MD PSC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ravi Pachigolla MD PSC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Morgan Priche Randolph
• Natasha Maria Randolph, M.S., CCC-SLP
• Michael Rankin
• Rylan Weston Ranta
• Melissa A Raschbaum, CRNA
• Anna Ray
• Stephany Larsen Reagan, PA-C
• Gayatri Reddy, M. D.
• Guduru Ramana Reddy, MD
• Rediclinic US, LLC

• Otolaryngology Physician in Weatherford, TX
• Providers in Weatherford, TX by specialty
• Otolaryngology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.