Individual provider Active NPI

Gemma M Sookprasong, DO

  • Family Medicine Physician
  • Cedar Hill, TX
National Provider Identifier
1386134757
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
S3880 Issued in TX
Practice address
294 Uptown Blvd Ste 100
Cedar Hill, TX 75104-3537
Phone
(972) 817-6300
NPI assigned
May 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X BP10063989 TX
Family Medicine Physician 207Q00000X S3880 TX Primary

Addresses

Primary practice location

294 Uptown Blvd Ste 100
Cedar Hill, TX 75104-3537

Mailing address

294 Uptown Blvd Ste 100
Cedar Hill, TX 75104-3537
Phone (972) 817-6300

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
I20211008001821 TX Practitioner - Family Practice 5294133013 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

294 Uptown Blvd
Suite 100
Cedar Hill, TX 75104-3537
Phone (972) 293-3569

Hospital & facility affiliations

  • Texas Home Health Group of Desoto, LLC Home health agency, Desoto, TX, CCN 679103
  • Baylor Scott & White Medical Center- Waxahachie Hospital, Waxahachie, TX, CCN 450372
  • Methodist Charlton Medical Center Hospital, Dallas, TX, CCN 450723
  • Baylor Scott & White Institute for Rehabilitation Inpatient rehabilitation facility, Dallas, TX, CCN 453036

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10063989TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network Family Medicine CurrentSince Sep 27, 2021 Accepting new patients
Healthtexas Provider Network CurrentSince Sep 27, 2021 Accepting new patients
Healthtexas Provider Network Family Medicine Past Accepting new patients

Locations

294 Uptown Blvd
Ste 100
Cedar Hill, TX 75104
Phone (972) 293-3569

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

301 N Washington Ave
Fl 5
Dallas, TX 75246
Phone (469) 800-8742

Interoperability endpoints

  • Direct secure messaging: gsookprasong330911@direct.sw.org

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1525996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1386134757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "294 UPTOWN BLVD STE 100",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751043537",
            "telephone_number": "972-817-6300",
            "fax_number": "254-313-4531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "294 UPTOWN BLVD STE 100",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751043537",
            "telephone_number": "972-817-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOOKPRASONG",
        "first_name": "GEMMA",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-11",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "BP10063989",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "S3880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Hill, TX

Sources for this page

Verify at the official NPI Registry.