Individual provider Active NPI

Rajendra Chhotalal Vassa, M.D.

  • Pediatric Adolescent Medicine Physician
  • McKinney, TX
National Provider Identifier
1386645406
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
G7018 Issued in TX
Practice address
6171 Virginia Pkwy
200
McKinney, TX 75071-5605
Phone
(972) 548-5363
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X G7018 TX Primary
Pediatrics Physician 208000000X G7018 TX

Addresses

Primary practice location

6171 Virginia Pkwy
200
McKinney, TX 75071-5605

Mailing address

PO Box 884
McKinney, TX 75070-8145
Phone (972) 548-5363

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
I20160523002669 TX Practitioner - Pediatric Medicine 4385933860 Practice locations: McKinney, TX

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
NRV Investments LLC PastSince Dec 1, 2019 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": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1386645406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 884",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750708145",
            "telephone_number": "972-548-5363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6171 VIRGINIA PKWY",
            "address_2": "200",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750715605",
            "telephone_number": "972-548-5363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASSA",
        "first_name": "RAJENDRA",
        "middle_name": "CHHOTALAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "TX",
            "license": "G7018",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "G7018",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKinney, TX

Sources for this page

Verify at the official NPI Registry.