Individual provider Active NPI

Paul Varughese, M.D.

  • Pediatrics Physician
  • Durant, OK
National Provider Identifier
1497800064
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
26824 Issued in OK
Practice address
1400 Bryan Dr Ste 201
Durant, OK 74701-2157
Phone
(580) 931-2290
Fax
(580) 931-2288
NPI assigned
Jan 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME 97642 FL
Pediatrics Physician 208000000X 26824 OK Primary

Addresses

Primary practice location

1400 Bryan Dr Ste 201
Durant, OK 74701-2157

Mailing address

1400 Bryan Dr Ste 201
Durant, OK 74701-2157
Phone (580) 931-2290

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address paul.varughese.2@4696.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20090728000831 OK Practitioner - Pediatric Medicine 9436202157 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 97642FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Durant Hma Physician Management, LLC Pediatrics CurrentSince Jun 15, 2009 Accepting new patients
Marshall County Hma, LLC CurrentSince Apr 13, 2020 Accepting new patients
Marshall County Hma LLC CurrentSince Apr 13, 2020 Accepting new patients
Marshall County Hma LLC Past Accepting new patients
Marshall County Hma, LLC Past Accepting new patients
Durant Hma LLC Past Accepting new patients

Locations

1400 Bryan Dr
Ste 301
Durant, OK 74701
Phone (580) 920-0105

1610 W University Blvd
Durant, OK 74701
Phone (580) 924-3400

1800 W University Blvd
Durant, OK 74701
Phone (580) 924-3080

1400 Bryan Dr
Ste 201
Durant, OK 74701
Phone (580) 924-4704

907 Hospital Dr
Madill, OK 73446
Phone (580) 795-0191

Interoperability endpoints

  • Direct secure messaging: paul.varughese.2@4696.direct.athenahealth.com

Organizations & group practices 6

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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1497800064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 BRYAN DR STE 201",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747012157",
            "telephone_number": "580-931-2290",
            "fax_number": "580-931-2288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 BRYAN DR STE 201",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747012157",
            "telephone_number": "580-931-2290",
            "fax_number": "580-931-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARUGHESE",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME 97642",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "26824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "paul.varughese.2@4696.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "address_1": "1610 W University Blvd",
            "city": "Durant",
            "state": "OK",
            "country_code": "US",
            "postal_code": "747013096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Durant, OK

Sources for this page

Verify at the official NPI Registry.