Individual provider Active NPI

Utpal Mondal, MD

  • Hospitalist Physician
  • Dallas, TX
National Provider Identifier
1578726923
Registry record updated Aug 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
P8807 Issued in TX
Practice address
5323 Harry Hines Boulevard
Dallas, TX 75390-7208
Phone
(214) 645-0624
Fax
(214) 645-0078
NPI assigned
Jul 7, 2008
Last updated
Aug 19, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X MD151262 OR
Hospitalist Physician 208M00000X P8807 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) 645-0624

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
I20141006000899 TX Practitioner - Internal Medicine 4587857867 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ipc Healthcare Services of Texas, PLLC Hospitalist CurrentSince Dec 4, 2016 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Oct 23, 2017 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC CurrentSince Aug 4, 2017 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Oct 23, 2017 Accepting new patients
Southwest Medical Associates, Inc. CurrentSince Apr 2, 2018 Accepting new patients

Locations

1416 George Dieter Dr
El Paso, TX 79936
Phone (877) 822-6281

551 Hill Country Dr
Kerrville, TX 78028
Phone (830) 257-5414

700 E Marshall Ave
Longview, TX 75601
Phone (903) 236-2000

111 Dallas St
San Antonio, TX 78205
Phone (210) 297-7000

1310 McCullough Ave
San Antonio, TX 78212
Phone (210) 208-2200

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • Direct secure messaging: umondal10800@shannonhealth.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408406400000",
    "number": "1578726923",
    "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": "214-645-0624",
            "fax_number": "214-645-0078"
        },
        {
            "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": "214-645-0624",
            "fax_number": "214-645-0078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONDAL",
        "first_name": "UTPAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-07",
        "last_updated": "2014-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OR",
            "license": "MD151262",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "P8807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.