Individual provider Active NPI

Rohan Venugopal Menon

  • Pediatrics Physician
  • Dallas, TX
National Provider Identifier
1407210982
Registry record updated Jul 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
S0337 Issued in TX
Practice address
7777 Forest Lane, BLDG B 300
Dallas, TX 75230
Phone
(972) 284-7770
Fax
(972) 284-7780
NPI assigned
Apr 11, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X S0337 TX Primary

Addresses

Primary practice location

7777 Forest Lane, BLDG B 300
Dallas, TX 75230

Mailing address

P.O. Box 961205
Fort Worth, TX 76161-1205
Phone (817) 740-8450

Other practice location 1

2323 N Houston St
Apt 504
Dallas, TX 75219-7626
Phone (214) 478-3340

Other practice location 2

6300 W Parker Rd Ste 126
Plano, TX 75093-8103
Phone (972) 526-0700

Other practice location 3

7777 Forest Lane, Bldg. B 308
Dallas, TX 75230-2571
Phone (972) 284-7770

Other practice location 4

1600 Republic Pkwy Ste 120
Mesquite, TX 75150-6918
Phone (972) 284-7770

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
I20190815002771 TX Practitioner - Pediatric Medicine 9133456940 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S0337TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Care, P.L.L.C. Current Accepting new patients
Texas Health Care, P.L.L.C. CurrentSince Jul 29, 2019 Accepting new patients
Texas Health Care, P.L.L.C. CurrentSince Jul 29, 2019 Accepting new patients
Forest Lane Pediatrics Pediatrics PastSince Aug 6, 2019 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas Past Accepting new patients

Locations

3500 Gaston Ave
Dallas, TX 75246

7777 Forest Ln
Ste B308
Dallas, TX 75230
Phone (972) 284-7770

7777 Forest Ln
Ste B300
Dallas, TX 75230
Phone (972) 284-7770

4461 Coit Rd
Ste 405
Frisco, TX 75035
Phone (972) 377-9200

2821 Lackland Rd
Ste 300
Ft Worth, TX 76116
Phone (817) 740-8400

1600 Republic Pkwy
Ste 120
Mesquite, TX 75150
Phone (972) 284-7770

6700 Buenos Aires Dr
North Richlnd Hls, TX 76180
Phone (817) 281-8245

6300 W Parker Rd
Ste 126
Plano, TX 75093
Phone (972) 526-0700

920 Santa Fe Dr
Ste 103
Weatherford, TX 76086
Phone (817) 339-8855

Interoperability endpoints

  • Direct secure messaging: rohan.menon.1@8042.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/9229/brand/1/csg/1/fhir/r4
  • Direct secure messaging: rohan.menon.p1@direct.thc.nextgenshare.com

Organizations & group practices 5

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": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1407210982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 961205",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761611205",
            "telephone_number": "817-740-8450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 FOREST LANE, BLDG B 300",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75230",
            "telephone_number": "972-284-7770",
            "fax_number": "972-284-7780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2323 N Houston St",
            "address_2": "Apt 504",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752197626",
            "country_code": "US",
            "telephone_number": "214-478-3340",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6300 W Parker Rd Ste 126",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750938103",
            "country_code": "US",
            "telephone_number": "972-526-0700",
            "fax_number": "972-526-0990",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7777 Forest Lane, Bldg. B 308",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752302571",
            "country_code": "US",
            "telephone_number": "972-284-7770",
            "fax_number": "972-284-7780",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 Republic Pkwy Ste 120",
            "address_purpose": "LOCATION",
            "city": "Mesquite",
            "state": "TX",
            "postal_code": "751506918",
            "country_code": "US",
            "telephone_number": "972-284-7770",
            "fax_number": "972-284-7780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENON",
        "first_name": "ROHAN",
        "middle_name": "VENUGOPAL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-11",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "S0337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.