Shailesh D Dhaduk, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

L2864 Issued in TX

Practice address

2709 Osler Blvd
Bryan, TX 77802-2518

Phone

(979) 776-2200

NPI assigned

Jul 21, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Family Practice

Education

Other, 1995

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI St Joseph Health Regional Hospital Hospital, Bryan, TX, CCN 450011

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Bryan Family Medicine Clinic, PA

  • Family Medicine Physician
  • Bryan, TX
  • NPI 1235193483
  Medicare reassignment NPD Authorized official
• Texas a&M University System Health Science Center

  dba Texas A&M Physicians - Round Rock

  • General Practice Physician
  • Round Rock, TX
  • NPI 1992957963
  NPD (past)

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

• St Joseph Regional Health Center

  • General Acute Care Hospital
  • Bryan, TX
  • NPI 1942294939
  Care Compare affiliation
• St. Joseph Regional Health Center

  dba CHI St. Joseph Health College Station Hospital

  • General Acute Care Hospital
  • College Station, TX
  • NPI 1053963009
  Care Compare affiliation

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1326047259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 OSLER BLVD",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022518",
            "telephone_number": "979-776-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2709 OSLER BLVD",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022518",
            "telephone_number": "979-776-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHADUK",
        "first_name": "SHAILESH",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L2864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TEXAS",
            "identifier": "8U4230",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Reena Desai
• Richard Devaul, M.D.
• Sydnei Devose-Fletcher, LMSW
• Phillip Jeremy Dew, MA, LPC, EMMHS, CMHS
• Stephanie Dewsnap, M.D.
• Diagnostic Foot Specialists
• Dialysis Newco LLC (U.S. Renal Care Bryan Dialysis)
• Katelin Sue Dias, PHD
• Autumn Michelle Dickerson
• Nancy Dickey, M.D.

• Family Medicine Physician in Bryan, TX
• Providers in Bryan, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.