Organization Active NPI

Madhavan Pisharodi, M.D., P.a.

  • Neurological Surgery Physician
  • Brownsville, TX
National Provider Identifier
1356480024
Registry record updated Nov 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
G0796 Issued in TX
Legal business name
MADHAVAN PISHARODI, M.D., P.A.
Practice address
3475 W Alton Gloor Blvd
Brownsville, TX 78520-9277
Phone
(956) 541-6725
Fax
(956) 541-2070
NPI assigned
Feb 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2011

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

Authorized official

Name
Subi Alex
Title
Office Manager
Phone
(956) 541-6725

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X G0796 TX Primary

Addresses

Primary practice location

3475 W Alton Gloor Blvd
Brownsville, TX 78520-9277

Mailing address

3475 W Alton Gloor Blvd
Brownsville, TX 78520-9277
Phone (956) 541-6725

Other identifiers 1

IdentifierTypeStateIssuer
081242201MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040614001562 TX Part B Supplier - Clinic/Group Practice 2163406539 Receives reassigned benefits from 4 practitioners
Practice locations: Brownsville, TX

National Provider Directory

National Provider Directory

Locations

4302 S Sugar Rd
Ste 209B
Edinburg, TX 78539

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320883200000",
    "number": "1356480024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3475 W ALTON GLOOR BLVD",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785209277",
            "telephone_number": "956-541-6725",
            "fax_number": "956-541-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3475 W ALTON GLOOR BLVD",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785209277",
            "telephone_number": "956-541-6725",
            "fax_number": "956-541-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADHAVAN PISHARODI, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2011-11-10",
        "status": "A",
        "authorized_official_last_name": "ALEX",
        "authorized_official_first_name": "SUBI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "956-541-6725"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "TX",
            "license": "G0796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "081242201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownsville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; 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.