NPIMap

Individual provider Active NPI

Raghuveer Vanguru, M.D.

  • Nephrology Physician
  • Fort Worth, TX
National Provider Identifier
1700891579
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
P3262 Issued in TX
Practice address
10700 Victoria Ash Dr
Fort Worth, TX 76244-6392
Phone
(817) 380-4168
Fax
(817) 562-5560
NPI assigned
Jul 30, 2006
Last updated
Aug 27, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X P3262 TX Primary

Addresses

Primary practice location

10700 Victoria Ash Dr
Fort Worth, TX 76244-6392

Mailing address

1600 Waters Ridge Dr Ste a
Lewisville, TX 75057-6039
Phone (940) 320-1708

Other identifiers 1

IdentifierTypeStateIssuer
307464301MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121010000094 TX Practitioner - Nephrology 4981600954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

10700 Victoria Ash Dr
Fort Worth, TX 76244-6392
Phone (817) 380-4167

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.77 of 100Reported as individual
Quality
99.47
Promoting interoperability
100
Improvement activities
40
Cost
59.76

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Texas Kidney Disease Associates Nephrology CurrentSince Oct 1, 2012 Accepting new patients
North Texas Kidney Disease Associates Nephrology CurrentSince Oct 1, 2012 Accepting new patients
Renal Center of Keller, LLC PastSince Jun 5, 2023 Accepting new patients

Locations

3315 Colorado Blvd
Ste 102
Denton, TX 76210
Phone (940) 320-1708

10700 Victoria Ash Dr
Fort Worth, TX 76244
Phone (817) 283-5166

1600 Waters Ridge Dr
Ste A
Lewisville, TX 75057
Phone (940) 320-1708

6331 Boulevard 26
Ste 220
North Richland Hills, TX 76180
Phone (817) 628-0284

Interoperability endpoints

  • Direct secure messaging: raghuveer.vanguru.1@23918.direct.athenahealth.com
  • Direct secure messaging: raghuveer.vanguru@northtexaskidney.directbygreenway.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1700891579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 WATERS RIDGE DR STE A",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750576039",
            "telephone_number": "940-320-1708",
            "fax_number": "940-320-1708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 VICTORIA ASH DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762446392",
            "telephone_number": "817-380-4168",
            "fax_number": "817-562-5560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANGURU",
        "first_name": "RAGHUVEER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "P3262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "307464301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.