Sudip K Bose

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

L5682 Issued in TX

Practice address

9229 LBJ Fwy
Dallas, TX 75243-3405

Phone

(972) 739-3710

NPI assigned

Apr 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Emergency Medicine

Education

Northwestern University Feinberg Medical School, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Round Table Physicians Group PLLCGroup PAC ID 0547682460, 80 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medical Center Hospital Hospital, Odessa, TX, CCN 450132

Merit-based Incentive Payment System (MIPS)

Final score

85.33 of 100Reported as group

Quality

74.13

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Round Table Physicians Group PLLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bellaire, TX
  • NPI 1023439114
  Medicare reassignment Care Compare group NPD
• Basin Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Odessa, TX
  • NPI 1831337724
  Medicare reassignment NPD
• Round Table Specialist Group, PLLC

  • Emergency Medicine Physician
  • Houston, TX
  • NPI 1497152268
  NPD
• Travis County Emergency Physicians PA

  • Emergency Medicine Physician
  • Austin, TX
  • NPI 1962440933
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ector County Hospital District

  • Federally Qualified Health Center (FQHC)
  • Odessa, TX
  • NPI 1578265302

  Hospital

  Care Compare affiliation
• Ector County Hospital District

  • General Acute Care Hospital
  • Odessa, TX
  • NPI 1740273994
  Care Compare affiliation

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238457600000",
    "number": "1679537260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9229 LBJ FWY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752433405",
            "telephone_number": "972-739-3710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9229 LBJ FWY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752433405",
            "telephone_number": "972-739-3710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSE",
        "first_name": "SUDIP",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2009-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "TX",
            "license": "L5682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Bortolasi Guimaraes
• Cristopher Lynn Borunda
• Julie Nelson Borus, MS, RDN, LD
• Zachary Alexander Borynack, PHD
• Jasmine Bose
• Somayeh Boshagh Cheghazali
• Chase Parker Bosley
• Nana Awa Bosomtwe, MD
• Piper Boss
• Rebecca Elizabeth Boss, PA-C

• Emergency Medical Services (Emergency Medicine) Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.