Individual provider Active NPI

Sarat Chandra Susarla, MD

  • Pediatric Pulmonology Physician
  • Houston, TX
National Provider Identifier
1356515829
Registry record updated Mar 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
M5530 Issued in TX
Practice address
902 Frostwood Dr
Suite 210
Houston, TX 77024-2420
Phone
(713) 464-4107
Fax
(713) 465-4522
NPI assigned
Apr 16, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X M5530 TX Primary

Addresses

Primary practice location

902 Frostwood Dr
Suite 210
Houston, TX 77024-2420

Mailing address

902 Frostwood Dr
Suite 210
Houston, TX 77024-2420
Phone (713) 464-4107

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080813000792 TX Practitioner - Pediatric Medicine 4082789821

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M5530TXMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Houston Pediatric Specialty Group PLLC Pediatric Pulmonology Past Accepting new patients

Organizations & group practices 1

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": "1208304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331510400000",
    "number": "1356515829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 FROSTWOOD DR",
            "address_2": "SUITE 210",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770242420",
            "telephone_number": "713-464-4107",
            "fax_number": "713-465-4522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 FROSTWOOD DR",
            "address_2": "SUITE 210",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770242420",
            "telephone_number": "713-464-4107",
            "fax_number": "713-465-4522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSARLA",
        "first_name": "SARAT",
        "middle_name": "CHANDRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-16",
        "last_updated": "2012-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "TX",
            "license": "M5530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.