Active NPI
Pavan K Thangudu, M.D.
- Critical Care Medicine (Internal Medicine) Physician
- Harrisburg, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine (Internal Medicine) Physician
- License
- R1661
- Practice address
- 4300 Londonderry Rd
Harrisburg, PA 17109-5317 - Phone
- (717) 231-8772
- Fax
- (717) 231-8435
- NPI assigned
- Mar 31, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD457573 | PA | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | R1661 | TX | Primary |
Addresses
Primary practice location
4300 Londonderry Rd
Harrisburg, PA 17109-5317
Mailing address
21 Spurs LN
Ste 230B
San Antonio, TX 78240-1671
Phone (210) 690-7400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103118689 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Critical Care (Intensivists)
- Education
- Temple University School of Medicine, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1111 Medical Plaza Dr
Suite 250
The Woodlands, TX 77380-3477
Phone (281) 296-8788
Hospital & facility affiliations
- Memorial Hermann Hospital System
- Woodland Heights Medical Center
- Memorial Hermann Northeast Hospital
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.
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Texas Ips LLC | Critical Care Medicine | Current | Accepting new patients |
| Wael Asi MD PA | Internal Medicine | Current | Accepting new patients |
| Baylor College of Medicine | Current | Accepting new patients | |
| Baylor College of Medicine | Internal Medicine | Current | Accepting new patients |
Locations
1125 Cypress Station Dr
Ste E
Houston, TX 77090
Phone (281) 419-5818
7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924
7200 Cambridge St
Fl 9
Houston, TX 77030
Phone (713) 798-2273
4499 Medical Dr
#150
San Antonio, TX 78229
Phone (210) 614-8181
21 Spurs Ln
Ste 230B
San Antonio, TX 78240
4458 Medical Dr
Ste 505
San Antonio, TX 78229
1111 Medical Plaza Dr
Ste 250
The Woodlands, TX 77380
Phone (281) 419-5818
Organizations & group practices 4
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.
-
- Critical Care Medicine (Internal Medicine) Physician
- The Woodlands, TX
- NPI 1851342794
-
- Orthopaedic Surgery Physician
- Sugar Land, TX
- NPI 1700683844
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Humble, TX
- NPI 1295843787
-
- General Acute Care Hospital
- Houston, TX
- NPI 1730132234
-
- General Acute Care Hospital
- Lufkin, TX
- NPI 1487607792
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502150400000",
"number": "1679898829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 SPURS LN",
"address_2": "STE 230B",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782401671",
"telephone_number": "210-690-7400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4300 LONDONDERRY RD",
"city": "HARRISBURG",
"state": "PA",
"postal_code": "171095317",
"telephone_number": "717-231-8772",
"fax_number": "717-231-8435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THANGUDU",
"first_name": "PAVAN",
"middle_name": "K",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-03-31",
"last_updated": "2017-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "MD457573",
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "TX",
"license": "R1661",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "103118689",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Harrisburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2017; 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.