Individual provider Active NPI

Raja Koteswar Dhanekula, MD

  • Gastroenterology Physician
  • Round Rock, TX
National Provider Identifier
1447546379
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
S9493 Issued in TX
Practice address
300 University Blvd BLDG a
Round Rock, TX 78665-1032
Phone
(512) 509-0200
Fax
(512) 509-2229
NPI assigned
Jun 20, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X S9493 TX
Transplant Hepatology Physician 207RT0003X S9493 TX
Gastroenterology Physician 207RG0100X S9493 TX Primary

Addresses

Primary practice location

300 University Blvd BLDG a
Round Rock, TX 78665-1032

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (254) 724-2111

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rdhanekula854350@direct.sw.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, TX2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20140910002570 PA Practitioner - GastroenterologyPractitioner - Internal Medicine 1759539141 Reassigns benefits to 1 organization
I20210730003093 TX Practitioner - GastroenterologyPractitioner - Hematology 1759539141 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

1300 E Polk St
Baylor Scott and White Clinic Burnet
Burnet, TX 78611-2136
Phone (512) 715-6400

1605 S 31St St
Baylor Scott and White Center for Dia
Temple, TX 76508-0001
Phone (254) 215-0100

1701 E Pflugerville Pkwy
Baylor Scott and White Clinic Pflug
Pflugerville, TX 78660-8990
Phone (512) 259-6000

239 W Business
190 Baylor Scott and White Clinic Coppe
Copperas Cove, TX 76522-2912
Phone (254) 542-9000

2401 S 31 St
Temple, TX 76508-0001
Phone (254) 724-2459

2401 S 31St St BLDG
35 Baylor Scott and White Roney Bone and
Temple, TX 76508-0001
Phone (254) 724-2663

2600 E Pflugerville Pkwy
BLDG 2
Pflugerville, TX 78660-5998
Phone (512) 654-6500

2608 Brockton Dr
Austin, TX 78758-4414
Phone (512) 654-4050

3108 Ranch Rd 620
Lakeway, TX 78738-5635
Phone (512) 654-4200

3141 Eagles Nest St
Unit 240
Round Rock, TX 78665-2334
Phone (512) 509-0200

425 University Blvd
Round Rock, TX 78665-1053
Phone (512) 509-0200

5245 W Hwy 290
Baylor Scott and White Medical Center Austi
Austin, TX 78735-8963
Phone (512) 654-2100

5251 W Hwy 290
Baylor Scott and White Clinic Austin Oak Hi
Austin, TX 78735-8963
Phone (512) 654-3000

5251 W Hwy 290 100
Baylor Scott and White Cancer and Infusion Ce
Austin, TX 78735-8963
Phone (512) 654-4319

5330 Overpass Rd
Buda, TX 78610-2300

6502 Lohmans Ford Rd
Lago Vista, TX 78645-5138
Phone (512) 267-3213

7451 W State Hwy 29
Baylor Scott and White Clinic Georg
Georgetown, TX 78628-6849
Phone (512) 509-8700

810 W U Ave
Temple, TX 76508-0001
Phone (254) 724-2585

9800 N Lake Creek Pkwy
200 Baylor Scott and White Clinic Austi
Austin, TX 78717-5947
Phone (512) 336-3400

Hospital & facility affiliations

  • Baylor Scott & White Medical Center - Round Rock Hospital, Round Rock, TX, CCN 670034
  • Baylor Scott & White Medical Center - Marble Falls Hospital, Marble Falls, TX, CCN 670108
  • Baylor Scott & White Medical Center - Temple Hospital, Temple, TX, CCN 450054
  • Baylor Scott & White Medical Center Pflugerville Hospital, Pflugerville, TX, CCN 670128
  • Baylor Scott & White Medical Center- Austin Hospital, Austin, TX, CCN 670136

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy23
Upper gastrointestinal (GI) endoscopy for acid reflux20

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S9493TXMDTransplant Hepatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Via Affiliates Current Accepting new patients
Via Affiliates Internal Medicine CurrentSince Aug 1, 2019 Accepting new patients
Scott & White Clinic Internal Medicine Current Accepting new patients
Scott & White Clinic Internal Medicine CurrentSince Jun 22, 2021 Accepting new patients
Scott and White Clinic Internal Medicine CurrentSince Jun 22, 2021 Accepting new patients
Via Affiliates CurrentSince Aug 1, 2019 Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients

Locations

599 W State St
Ste 200
Doylestown, PA 18901
Phone (215) 345-6050

595 W State St
Doylestown, PA 18901
Phone (215) 345-2200

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

310 E Highway 67
Duncanville, TX 75137
Phone (469) 800-9000

1701 E Pflugerville Pkwy
Pflugerville, TX 78660
Phone (512) 259-6000

300 University Blvd
Bldg A
Round Rock, TX 78665
Phone (512) 509-0100

3141 Eagles Nest St
Ste 240
Round Rock, TX 78665

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

2401 S 31st St
#200
Temple, TX 76508
Phone (254) 215-0100

Organizations & group practices 7

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 6

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": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1447546379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 UNIVERSITY BLVD BLDG A",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651032",
            "telephone_number": "512-509-0200",
            "fax_number": "512-509-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHANEKULA",
        "first_name": "RAJA KOTESWAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-20",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "S9493",
            "primary": false
        },
        {
            "code": "207RT0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Transplant Hepatology",
            "state": "TX",
            "license": "S9493",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "S9493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rdhanekula854350@direct.sw.org",
            "affiliation": "N",
            "address_1": "300 University Blvd Bldg A",
            "city": "Round Rock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786651032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

Verify at the official NPI Registry.