Shruti Surya, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

38571 Issued in TX

Practice address

1700 University Dr E
College Station, TX 77840-2661

Phone

(979) 691-3300

Fax

(979) 691-3527

NPI assigned

Jul 10, 2018

Last updated

Mar 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Clinical Psychologist

Education

Texas a & M University System, HSC, College of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baylor Scott & White Medical Center- College Stati Hospital, College Station, TX, CCN 670088

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Scott & White Clinic

  dba Baylor Scott & White Clinic - Temple

  • Internal Medicine Physician
  • Temple, TX
  • NPI 1093779704
  Medicare reassignment Care Compare group
• Scott & White Clinic

  • Internal Medicine Physician
  • College Station, TX
  • NPI 1922061993
  NPD

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

• Scott & White Hospital - College Station

  dba Baylor Scott & White Medical Center - College Station

  • General Acute Care Hospital
  • College Station, TX
  • NPI 1265772362
  Care Compare affiliation

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1346736543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 UNIVERSITY DR E",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778402661",
            "telephone_number": "979-691-3300",
            "fax_number": "979-691-3527"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 S 31st St # MS 22103E",
            "address_purpose": "LOCATION",
            "city": "Temple",
            "state": "TX",
            "postal_code": "765080001",
            "country_code": "US",
            "telephone_number": "254-724-3874",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7901 Metropolis Dr",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787443111",
            "country_code": "US",
            "telephone_number": "512-823-4040 x54687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SURYA",
        "first_name": "SHRUTI",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-10",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "TX",
            "license": "38571",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ssurya419433@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1700 University Dr E",
            "city": "College Station",
            "state": "TX",
            "country_code": "US",
            "postal_code": "778402661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Counseling Psychologist in College Station, TX
• Providers in College Station, TX by specialty
• Counseling Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.