Individual provider Active NPI

Elvin Varughesekutty, D.O

  • Internal Medicine Physician
  • Scranton, PA
National Provider Identifier
1679955900
Registry record updated Jun 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OT016794 Issued in PA
Practice address
501 Madison Ave
Scranton, PA 18510-2401
Phone
(570) 343-2383
NPI assigned
Jun 23, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OT016794 PA Primary

Addresses

Primary practice location

501 Madison Ave
Scranton, PA 18510-2401

Mailing address

501 Madison Ave
Scranton, PA 18510-2401
Phone (570) 343-2383

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181212001116 TX Practitioner - Internal Medicine 2769783828 Reassigns benefits to 2 organizations
I20190327002421 OR Practitioner - Internal Medicine 2769783828 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
William Carey University College of Osteopathic Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ipc Healthcare Services of Texas PLLCGroup PAC ID 3971824939, 184 clinicians

Practice addresses (Care Compare)

12221 N Mopac Expy
Austin, TX 78758-2401
Phone (512) 901-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OT016794PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Physicians Group-Pannu PLLC Internal Medicine CurrentSince Jan 7, 2019 Accepting new patients
Ipc Healthcare Services of Texas, PLLC Internal Medicine CurrentSince Nov 2, 2018 Accepting new patients
Lonestar Pat Associates PA Internal Medicine CurrentSince Sep 29, 2020 Accepting new patients
St. David'S Healthcare Partnership, L.P., LLP Past Accepting new patients
Lonestar Hospital Medicine Associates, PA Internal Medicine Past Accepting new patients

Locations

5575 Dtc Pkwy
Ste 225
Greenwood Village, CO 80111

1300 E 5th Ave
Winfield, KS 67156
Phone (620) 221-2300

10624 S Eastern Ave
Ste A436
Henderson, NV 89052

94220 4th St
Gold Beach, OR 97444
Phone (541) 247-3000

10300 NE Hancock St
Portland, OR 97220
Phone (503) 257-5500

1460 G St
Springfield, OR 97477
Phone (541) 431-0665

901 W Ben White Blvd
Austin, TX 78704
Phone (512) 342-2382

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

2000 Scenic Dr
Georgetown, TX 78626
Phone (512) 863-2117

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

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

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435017600000",
    "number": "1679955900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 MADISON AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185102401",
            "telephone_number": "570-343-2383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 MADISON AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185102401",
            "telephone_number": "570-343-2383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARUGHESEKUTTY",
        "first_name": "ELVIN",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-23",
        "last_updated": "2015-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OT016794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.