Individual provider Active NPI

Pramodh Kumar Wadera, M.D.

  • Anesthesiology Physician
  • Houston, TX
National Provider Identifier
1417949553
Registry record updated Jul 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
G1575 Issued in TX
Practice address
1500 Citywest Blvd Ste 300
Houston, TX 77042-2549
Phone
(972) 233-1999
NPI assigned
Aug 16, 2005
Last updated
Jul 31, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X G1575 TX Primary
Anesthesiology Physician 207L00000X 036073410 IL
Pain Medicine (Anesthesiology) Physician 207LP2900X G1575 TX
Interventional Pain Medicine Physician 208VP0014X G1575 TX

Addresses

Primary practice location

1500 Citywest Blvd Ste 300
Houston, TX 77042-2549

Mailing address

PO Box 840853
Dallas, TX 75284-6404
Phone (972) 715-5000

Other practice location 1

201 S 14th St
Herrin, IL 62948-3631
Phone (618) 942-2171 ext. 65137

Other practice location 2

405 W Jackson St
Carbondale, IL 62901-1462
Phone (618) 549-0721 ext. 65137

Other practice location 3

303 Sandy Corner Rd
El Campo, TX 77437-9535
Phone (281) 265-0774

Other identifiers 5

IdentifierTypeStateIssuer
214881OtherILMEDICARE GROUP PTAN
136242810MedicaidTX
89807BOtherTXBLUE CROSS BLUE SHIELD
136242809MedicaidTX
136242811MedicaidTX

Other names 1

  • Dr. P K (Bobby) Wadera Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, IL, AZ3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20050929000614 TX Practitioner - AnesthesiologyPractitioner - Interventional Pain Management 9436184512 Reassigns benefits to 13 organizations
I20200325000139 IL Practitioner - Anesthesiology 9436184512 Reassigns benefits to 1 organization
I20210709000081 AZ Practitioner - Anesthesiology 9436184512 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Interventional Pain Management
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
U S Anesthesia Partners of Texas, PAGroup PAC ID 7315850351, 2,750 clinicians

Practice addresses (Care Compare)

16100 S Fwy
Pearland, TX 77584-1895
Phone (713) 413-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036073410ILMDAnesthesiology Physician
G1575TXMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Dynamics LLC Anesthesiology CurrentSince Nov 1, 2021 Accepting new patients
Greater Anesthesia Solutions Anesthesiology CurrentSince Jun 1, 2021 Accepting new patients
Hospitalist Medicine Physicians of Texas - Dallas PLLC Anesthesiology CurrentSince Aug 1, 2022 Accepting new patients
Texas Ams PLLC Anesthesiology CurrentSince Jan 21, 2021 Accepting new patients
Lone Star Anesthesia Associates, PLLC Anesthesiology CurrentSince Jul 1, 2023 Accepting new patients
Texans Anesthesia Associates PLLC Anesthesiology CurrentSince Sep 24, 2018 Accepting new patients
Sound Physicians Anesthesiology of Texas PLLC Anesthesiology CurrentSince Jun 1, 2021 Accepting new patients
Premier Anesthesia of Huntsville a Division of Premier Anesthesia LLC Anesthesiology CurrentSince Sep 1, 2017 Accepting new patients
Dynamic Anesthesia Providers PLLC Anesthesiology CurrentSince Feb 14, 2024 Accepting new patients
Emergenchealth PLLC Anesthesiology CurrentSince Oct 1, 2021 Accepting new patients
Hospitalist Medicine Physicians of Arizona - Nogales Anesthesiology CurrentSince Sep 22, 2021 Accepting new patients
Austin Anesthesiology Group PLLC Anesthesiology CurrentSince May 1, 2023 Accepting new patients
Endo Sedation LLC Anesthesiology CurrentSince Apr 1, 2019 Accepting new patients
Endo Sedation LLC Anesthesiology CurrentSince Apr 1, 2019 Accepting new patients
Austin Anesthesiology Group, PLLC Anesthesiology CurrentSince May 1, 2023 Accepting new patients
Compass Anesthesia Providers PLLC Anesthesiology CurrentSince May 1, 2020 Accepting new patients
Southern Illinois Medical Services, NFP CurrentSince Feb 12, 2020 Accepting new patients
Globe Crna Company, LLC Past Accepting new patients
Ahp Associates of Texas, PA Anesthesiology Past Accepting new patients

Locations (25 of 47)

5656 S Power Rd
Gilbert, AZ 85295
Phone (480) 840-3733

18701 N 67th Ave
Glendale, AZ 85308
Phone (623) 561-1000

5880 S Hospital Dr
Globe, AZ 85501
Phone (928) 402-1217

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

1800 E Van Buren St
Phoenix, AZ 85006
Phone (602) 251-8100

1601 W Saint Marys Rd
Tucson, AZ 85745
Phone (520) 622-5833

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

405 W Jackson St
Carbondale, IL 62901

201 S 14th St
Herrin, IL 62948
Phone (618) 942-2171

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

8015 Shoal Creek Blvd
Austin, TX 78757
Phone (512) 971-1519

4201 Garth Rd
Ste 212
Baytown, TX 77521
Phone (281) 420-9355

3944 Ranch Road 620 S
Bldg 8
Bee Cave, TX 78738
Phone (512) 263-1113

676 FM 517 Rd W
Dickinson, TX 77539
Phone (713) 335-9571

1815 N Stanton St
El Paso, TX 79902
Phone (915) 533-8412

1001 Surrey Ln
Flower Mound, TX 75022
Phone (817) 337-3671

5501 S Expressway 77
Harlingen, TX 78550
Phone (936) 569-9481

1401 St Joseph Pkwy
Houston, TX 77002
Phone (713) 575-1000

1635 North Loop W
Houston, TX 77008
Phone (713) 867-2066

3030 S Gessner Rd
Ste 150
Houston, TX 77063
Phone (713) 587-0909

4615 Southwest Fwy
Ste 850
Houston, TX 77027
Phone (281) 475-4428

510 W Tidwell Rd
Houston, TX 77091
Phone (281) 618-8500

7700 Fannin St
Houston, TX 77054
Phone (713) 790-1349

19502 McKay Dr
Ste 101
Humble, TX 77338
Phone (281) 312-6900

23920 Katy Fwy
Ste 200
Katy, TX 77494
Phone (281) 644-3200

Interoperability endpoints

  • Direct secure messaging: pramodh.wadera.1@13131.direct.athenahealth.com
  • Direct secure messaging: pwadera468881@direct.stlukeshealth.org

Organizations & group practices 20

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.

View all 20

Hospital & facility affiliations 7

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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1417949553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840853",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752846404",
            "telephone_number": "972-715-5000",
            "fax_number": "281-265-0774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 CITYWEST BLVD STE 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770422549",
            "telephone_number": "972-233-1999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 S 14th St",
            "address_purpose": "LOCATION",
            "city": "Herrin",
            "state": "IL",
            "postal_code": "629483631",
            "country_code": "US",
            "telephone_number": "618-942-2171 x65137",
            "fax_number": "618-351-4919",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 W Jackson St",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629011462",
            "country_code": "US",
            "telephone_number": "618-549-0721 x65137",
            "fax_number": "618-529-0449",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "303 Sandy Corner Rd",
            "address_purpose": "LOCATION",
            "city": "El Campo",
            "state": "TX",
            "postal_code": "774379535",
            "country_code": "US",
            "telephone_number": "281-265-0774",
            "fax_number": "281-265-0774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WADERA",
        "first_name": "PRAMODH",
        "middle_name": "KUMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "G1575",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036073410",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "TX",
            "license": "G1575",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "TX",
            "license": "G1575",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "214881",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136242810",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "89807B",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136242809",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136242811",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "P",
            "last_name": "WADERA",
            "middle_name": "K (BOBBY)",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.