NPIMap

Organization Active NPI

Surecure LLC

  • Physical Therapy Clinic/Center
  • Carrollton, TX
National Provider Identifier
1356840425
Registry record updated Mar 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
SURECURE LLC
Practice address
4541 N Josey LN Ste 130
Carrollton, TX 75010-4662
Phone
(469) 212-8888
Fax
(469) 212-8899
NPI assigned
Feb 5, 2018
Last updated
Mar 27, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2019

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

Authorized official

Name
Ms. Sanket Vyas
Title
Owner
Phone
(972) 765-5558

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

4541 N Josey LN Ste 130
Carrollton, TX 75010-4662

Mailing address

4543 Blackfoot St
Carrollton, TX 75010-3306

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180924003341 TX Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0840541223 Receives reassigned benefits from 5 practitioners
Practice locations: Carrollton, TX

National Provider Directory

National Provider Directory

Locations

4541 N Josey Ln
Ste 130
Carrollton, TX 75010
Phone (469) 212-8888

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1517788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553644800000",
    "number": "1356840425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4543 BLACKFOOT ST",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750103306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4541 N JOSEY LN STE 130",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750104662",
            "telephone_number": "469-212-8888",
            "fax_number": "469-212-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURECURE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-05",
        "last_updated": "2019-03-27",
        "status": "A",
        "authorized_official_last_name": "VYAS",
        "authorized_official_first_name": "SANKET",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-765-5558",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2019; 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.