Organization Active NPI

S Iyer PA

  • Pulmonary Disease Physician
  • Denton, TX
National Provider Identifier
1700117355
Registry record updated Mar 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
S IYER PA
Practice address
802 North Bonnie Brae Street
Suite 104
Denton, TX 76201-2301
Phone
(940) 565-0373
Fax
(940) 565-0413
NPI assigned
Jan 21, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2016

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

Authorized official

Name
Dr. Sridhar K Iyer, MDNPI 1043299712
Title
MD/Owner
Phone
(940) 565-0373

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X Primary
Sleep Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RS0012X

Addresses

Primary practice location

802 North Bonnie Brae Street
Suite 104
Denton, TX 76201-2301

Mailing address

PO Box 50658
Denton, TX 76206-0658
Phone (940) 565-0373

Other identifiers 1

IdentifierTypeStateIssuer
213642601MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100618000475 TX Part B Supplier - Clinic/Group Practice 9436289345 Receives reassigned benefits from 3 practitioners
Practice locations: Denton, TX

National Provider Directory

National Provider Directory

Locations

802 N Bonnie Brae St
Ste 104
Denton, TX 76201
Phone (469) 645-1155

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1264032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459123200000",
    "number": "1700117355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50658",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762060658",
            "telephone_number": "940-565-0373",
            "fax_number": "940-565-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 NORTH BONNIE BRAE STREET",
            "address_2": "SUITE 104",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762012301",
            "telephone_number": "940-565-0373",
            "fax_number": "940-565-0413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S IYER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-21",
        "last_updated": "2016-03-28",
        "status": "A",
        "authorized_official_last_name": "IYER",
        "authorized_official_first_name": "SRIDHAR",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "940-565-0373",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213642601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.