Individual provider Active NPI

Deepak Raj Paudel

  • Medical Physician Assistant
  • Rosharon, TX
National Provider Identifier
1346897220
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA15155 Issued in TX
Practice address
15030 Highway 6
Rosharon, TX 77583-3261
Phone
(832) 595-7717
NPI assigned
Aug 24, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA15155 TX Primary

Addresses

Primary practice location

15030 Highway 6
Rosharon, TX 77583-3261

Mailing address

4947 Lenox Grove LN
Rosharon, TX 77583-4707

Other practice location 1

7311 E Southern Ave Apt 2059
Mesa, AZ 85209-2714
Phone (832) 232-1548

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260509000178 TX Practitioner - Physician Assistant 5193262715 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

15030 Hwy 6
Rosharon, TX 77583

4947 Lenox Grove LN
Rosharon, TX 77583-4707

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA15155TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Care Physician of Rosharon PLLC CurrentSince Jul 1, 2024 Accepting new patients
Care Physician of Rosharon PLLC Current Accepting new patients

Locations

15030 Highway 6
Rosharon, TX 77583
Phone (832) 400-2050

Organizations & group practices 2

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": "1566604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1346897220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4947 LENOX GROVE LN",
            "city": "ROSHARON",
            "state": "TX",
            "postal_code": "775834707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15030 HIGHWAY 6",
            "city": "ROSHARON",
            "state": "TX",
            "postal_code": "775833261",
            "telephone_number": "832-595-7717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7311 E Southern Ave Apt 2059",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852092714",
            "country_code": "US",
            "telephone_number": "832-232-1548",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAUDEL",
        "first_name": "DEEPAK",
        "middle_name": "RAJ",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-24",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA15155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosharon, TX

Sources for this page

Verify at the official NPI Registry.