Sundance Physician Services, Inc

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

SUNDANCE PHYSICIAN SERVICES, INC

Practice address

7500 Rialto Blvd Ste 1-140
Austin, TX 78735-8534

Phone

(512) 730-3060

Fax

(888) 730-1925

NPI assigned

Jul 8, 2016

Organization subpart

No

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

Authorized official

Name

Ryan Carletti

Title

VP of Operations

Phone

(330) 727-3530

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1467936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692057600000",
    "number": "1326490889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 RIALTO BLVD STE 1-140",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787358534",
            "telephone_number": "512-730-3060",
            "fax_number": "888-730-1925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 RIALTO BLVD STE 1-140",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787358534",
            "telephone_number": "512-730-3060",
            "fax_number": "888-730-1925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNDANCE PHYSICIAN SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-08",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A",
        "authorized_official_last_name": "CARLETTI",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "330-727-3530"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36756901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Shichen Sun, MD
• Kennedy Sun, MD
• Melissa Sun
• Suncrest Hospice Austin LLC (Suncrest Hospice)
• Sundance Medical Services, Inc
• Megana Sundar, DO
• Varun Sundaram, MD
• Shiyamali Sundararajan
• Madhu Sundarrajan
• Kristin Elizabeth Sundberg, L.AC., MAOM

• Emergency Medicine Physician in Austin, TX
• Providers in Austin, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.