NPIMap

Organization Active NPI

Nidraveda, P.a.

  • Medical Specialty Clinic/Center
  • Shavano Park, TX
National Provider Identifier
1457773350
Registry record updated May 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
P2828 Issued in TX
Legal business name
NIDRAVEDA, P.A.
Practice address
4358 Lockhill Selma Rd Ste 106
Shavano Park, TX 78249-4167
Phone
(210) 686-5000
Fax
(210) 239-5060
NPI assigned
Jan 10, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2019

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

Authorized official

Name
Dr. Hanul S Bhandari, M.D.NPI 1053572164
Title
Owner
Phone
(210) 686-5000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X P2828 TX Primary
Sleep Disorder Diagnostic Clinic/Center 261QS1200X P2828 TX

Addresses

Primary practice location

4358 Lockhill Selma Rd Ste 106
Shavano Park, TX 78249-4167

Mailing address

4358 Lockhill Selma Rd Ste 106
Shavano Park, TX 78249-4167
Phone (210) 686-5000

Other practice location 1

4402 Vance Jackson Rd Ste 248
San Antonio, TX 78230-5334
Phone (210) 686-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150113000637 TX Part B Supplier - Clinic/Group Practice 5294059697 Receives reassigned benefits from 1 practitioner
Practice locations: Shavano Park, TX

National Provider Directory

National Provider Directory

Locations

2128 Babcock Rd
Bldg 1B
San Antonio, TX 78229

4358 Lockhill Selma Rd
Ste 106
Shavano Park, TX 78249
Phone (210) 686-5000

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1389312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558483200000",
    "number": "1457773350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4358 LOCKHILL SELMA RD STE 106",
            "city": "SHAVANO PARK",
            "state": "TX",
            "postal_code": "782494167",
            "telephone_number": "210-686-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4358 LOCKHILL SELMA RD STE 106",
            "city": "SHAVANO PARK",
            "state": "TX",
            "postal_code": "782494167",
            "telephone_number": "210-686-5000",
            "fax_number": "210-239-5060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4402 Vance Jackson Rd Ste 248",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782305334",
            "country_code": "US",
            "telephone_number": "210-686-5000",
            "fax_number": "210-239-5060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NIDRAVEDA, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-10",
        "last_updated": "2019-05-22",
        "status": "A",
        "authorized_official_last_name": "BHANDARI",
        "authorized_official_first_name": "HANUL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-686-5000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "TX",
            "license": "P2828",
            "primary": true
        },
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": "TX",
            "license": "P2828",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shavano Park, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.