Surendra Haridas Raythatha, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

Q1717 Issued in TX

Practice address

7821 FM 1960 Rd E
Atascocita, TX 77346-2205

Phone

(832) 644-8930

NPI assigned

Jul 5, 2007

Last updated

Mar 4, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

Family Practice

Education

Other, 1967

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Rajiv Agarwal MD PAGroup PAC ID 6305184011, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CACGBD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rajiv Agarwal MD PA

  dba Modern Heart and Vascular Institute

  • Cardiovascular Disease Physician
  • Humble, TX
  • NPI 1720550015
  Medicare reassignment Care Compare group NPD
• Rajiv Agarwal MD PA

  dba Modern Rehabilitation Center

  • Cardiac Rehabilitation Clinic/Center
  • Humble, TX
  • NPI 1598407017
  NPD
• Vytalus Medical Group, PLLC

  • Family Medicine Physician
  • Kingwood, TX
  • NPI 1053631275
  NPD (past)

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1407054026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18980 W MEMORIAL DR STE 100",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773384559",
            "telephone_number": "832-644-8930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7821 FM 1960 RD E",
            "city": "ATASCOCITA",
            "state": "TX",
            "postal_code": "773462205",
            "telephone_number": "832-644-8930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4672 Hill St",
            "address_purpose": "LOCATION",
            "city": "Cass City",
            "state": "MI",
            "postal_code": "487261028",
            "country_code": "US",
            "telephone_number": "989-872-5010",
            "fax_number": "989-872-9942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAYTHATHA",
        "first_name": "SURENDRA",
        "middle_name": "HARIDAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-05",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "SR040618",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q1717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0790012",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2763572",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sherrell Petty, NP
• Alexis Michele Phillips, D.O.
• Abagail Pisano, OTR/L
• David Plath, PHARM.D.
• Bonita Ramirez, PHYSICAL THERAPIST
• Rediclinic LLC
• Kelita Reynolds
• Donjha Renee Rodriguez-Maddox, LPC-A
• August Ross
• Sky Dental, P.a.

• Family Medicine Physician in Atascocita, TX
• Providers in Atascocita, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.