Individual provider Active NPI

Ravindra Mohan Bharadwaj, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Dallas, TX
National Provider Identifier
1477526044
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
Q2739 Issued in TX
Practice address
5939 Harry Hines Blvd 8TH Floor Ste HQ08.124
Dallas, TX 75390-1786
Phone
(214) 645-8650
NPI assigned
Feb 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 43992 TX
Internal Medicine Physician 207R00000X 01056005A IN
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 44727 TX
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 43992 TX
Geriatric Medicine (Internal Medicine) Physician 207RG0300X Q2739 TX Primary

Addresses

Primary practice location

5939 Harry Hines Blvd 8TH Floor Ste HQ08.124
Dallas, TX 75390-1786

Mailing address

PO Box 845347 PO Box 845347
Dallas, TX 75284-7298

Other identifiers 6

IdentifierTypeStateIssuer
303346601MedicaidTX
20447390 AMedicaidOK
01056005AOtherINSTATE LICENSURE
303346602MedicaidTX
200425170AMedicaidIN
75152835MedicaidNM

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
I20120910000310 TX Practitioner - Geriatric MedicinePractitioner - Internal Medicine 4183896673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Texas Southwestern Medical Center at DallasGroup PAC ID 0648188250, 3,156 clinicians

Practice addresses (Care Compare)

5939 Harry Hines Blvd
Dallas, TX 75235-6246
Phone (214) 645-0624

Hospital & facility affiliations

  • Ut of Texas Southwestern University Hospital - William P. Clements Jr. Hospital, Dallas, TX, CCN 450044

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01056005AINMDInternal Medicine Physician
Q2739TXMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Sep 1, 2021 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas Internal Medicine CurrentSince Sep 1, 2021 Accepting new patients
Earnest Associates Inc Past Accepting new patients
Major Hospital Past Accepting new patients

Locations

5939 Harry Hines Blvd
Fl 8
Dallas, TX 75235
Phone (214) 645-1460

6201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 633-4700

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

5939 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 645-1919

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

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.

Hospital & facility affiliations 1

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1477526044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347 PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752847298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5939 HARRY HINES BLVD 8TH FLOOR STE HQ08.124",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753901786",
            "telephone_number": "214-645-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHARADWAJ",
        "first_name": "RAVINDRA",
        "middle_name": "MOHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2023-03-07",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "43992",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01056005A",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "TX",
            "license": "44727",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "TX",
            "license": "43992",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "TX",
            "license": "Q2739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303346601",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20447390 A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSURE",
            "identifier": "01056005A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303346602",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200425170A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "75152835",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.