Individual provider Active NPI

Ashish Thekkekara Biju, DPM

  • Podiatrist
  • Longview, TX
National Provider Identifier
1518661289
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
692308 Issued in TX
Practice address
3133 Good Shepherd Way
Longview, TX 75605-7921
Phone
(903) 323-6500
Fax
(903) 315-4699
NPI assigned
Mar 28, 2023
Last updated
Jun 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 692308 TX Primary

Addresses

Primary practice location

3133 Good Shepherd Way
Longview, TX 75605-7921

Mailing address

3811 Jackson Shoals Dr
Lawrenceville, GA 30044-4065
Phone (678) 619-7860

Other practice location 1

2790 Godwin Blvd Ste 355
Suffolk, VA 23434-8173
Phone (757) 635-0784

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230821001742 VA Order and Referring Only - PodiatryPractitioner - Podiatry 3577925767

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1679961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1518661289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3811 JACKSON SHOALS DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300444065",
            "telephone_number": "678-619-7860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3133 GOOD SHEPHERD WAY",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756057921",
            "telephone_number": "903-323-6500",
            "fax_number": "903-315-4699"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2790 Godwin Blvd Ste 355",
            "address_purpose": "LOCATION",
            "city": "Suffolk",
            "state": "VA",
            "postal_code": "234348173",
            "country_code": "US",
            "telephone_number": "757-635-0784",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BIJU",
        "first_name": "ASHISH",
        "middle_name": "THEKKEKARA",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-28",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TX",
            "license": "692308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.