Individual provider Active NPI

Bruno Cunha de Medeiros

  • Pediatric Radiology Physician
  • Dallas, TX
National Provider Identifier
1689363095
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
48655 Issued in TX
Practice address
5323 Harry Hines Blvd
Dallas, TX 75390-7701
Phone
(214) 456-4036
NPI assigned
May 2, 2023
Reactivated
Mar 3, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology Physician 2085P0229X 48655 TX Primary

Addresses

Primary practice location

5323 Harry Hines Blvd
Dallas, TX 75390-7701

Mailing address

PO Box 845347
Dallas, TX 75284-5347
Phone (214) 456-1914

Other practice location 1

1935 Medical District Dr
Dallas, TX 75235-7701
Phone (214) 456-1914

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
I20250702000047 TX Practitioner - Diagnostic RadiologyPractitioner - Pediatric Medicine 9335652353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Pediatric Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Texas Southwestern Medical Center at DallasGroup PAC ID 0648188250, 3,156 clinicians

Practice addresses (Care Compare)

1935 Medical District Dr
Dallas, TX 75235-7701
Phone (844) 424-4537

Hospital & facility affiliations

  • Childrens Medical Ctr of Dallas Hospital, Dallas, TX, CCN 453302

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Aug 1, 2025 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Aug 1, 2025 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas Past Accepting new patients

Locations

10057 County Road 472
Anna, TX 75409

1935 Medical District Dr
Dallas, TX 75235
Phone (214) 456-2735

5184 Tex Oak Ave
Fl 5
Dallas, TX 75235
Phone (214) 266-9750

5151 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-3000

1801 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2035

2350 N Stemmons Fwy
Dallas, TX 75207
Phone (469) 488-7100

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

400 W Magnolia Ave
Ft Worth, TX 76104
Phone (817) 288-9700

3030 Waterview Pkwy
Richardson, TX 75080
Phone (972) 669-7070

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Interoperability endpoints

  • Direct secure messaging: bdemedeiros779512@direct.childrens.com

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.

Hospital & facility affiliations 1

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": "1682985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1689363095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752845347",
            "telephone_number": "214-456-1914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753907701",
            "telephone_number": "214-456-4036"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1935 Medical District Dr",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752357701",
            "country_code": "US",
            "telephone_number": "214-456-1914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUNHA DE MEDEIROS",
        "first_name": "BRUNO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-02",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "deactivation_date": "2023-12-07",
        "reactivation_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "TX",
            "license": "48655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.