Individual provider Active NPI

Bhaskar Gurram, M.D

  • Pediatric Gastroenterology Physician
  • Dallas, TX
National Provider Identifier
1528244597
Registry record updated Aug 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
Q3683 Issued in TX
Practice address
5323 Harry Hines Boulevard
Dallas, TX 75390-7208
Phone
(214) 648-3903
Fax
(214) 648-2481
NPI assigned
Jan 21, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301090411 MI
Pediatrics Physician 208000000X 53886 WI
Pediatric Gastroenterology Physician 2080P0206X 53886 WI
Pediatric Gastroenterology Physician 2080P0206X Q3683 TX Primary

Addresses

Primary practice location

5323 Harry Hines Boulevard
Dallas, TX 75390-7208

Mailing address

P.O. Box 845347
Dallas, TX 75284-5347
Phone (214) 648-3903

Other identifiers 1

IdentifierTypeStateIssuer
1528244597MedicaidWI

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
I20150716002637 TX Practitioner - Pediatric MedicinePractitioner - Gastroenterology 7012191224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Gastroenterology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5323 Harry Hines Blvd
Dallas, TX 75390-7208
Phone (216) 648-0600

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301090411MIMDPediatrics Physician
53886WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Aug 3, 2015 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Pediatrics CurrentSince Aug 3, 2015 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Past Accepting new patients
Children'S Health System of Texas Past Accepting new patients

Locations

1935 Medical District Dr
Ste EL171
Dallas, TX 75235

2222 Welborn St
Dallas, TX 75219
Phone (214) 559-5000

600 S Main St
Ft Worth, TX 76104
Phone (817) 882-2400

420 E 6th St
Ste 202
Odessa, TX 79761
Phone (214) 648-9618

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.

NPI Registry JSON

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

{
    "created_epoch": "1200873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439769600000",
    "number": "1528244597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752845347",
            "telephone_number": "214-648-3903",
            "fax_number": "214-648-2481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BOULEVARD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753907208",
            "telephone_number": "214-648-3903",
            "fax_number": "214-648-2481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURRAM",
        "first_name": "BHASKAR",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-21",
        "last_updated": "2015-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301090411",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "53886",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "WI",
            "license": "53886",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "TX",
            "license": "Q3683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528244597",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.