Individual provider Active NPI

Prabhat V S Uppuluri, D.O.

  • Internal Medicine Physician
  • Dallas, TX
National Provider Identifier
1710322011
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
Q7975 Issued in TX
Practice address
3600 Gaston Ave
Wadley Suite 550
Dallas, TX 75246-1800
Phone
(214) 821-1177
Fax
(214) 821-1193
NPI assigned
May 1, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

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 Q7975 TX Primary

Addresses

Primary practice location

3600 Gaston Ave
Wadley Suite 550
Dallas, TX 75246-1800

Mailing address

3600 Gaston Ave
Wadley Suite 550
Dallas, TX 75246-1800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address puppuluri262411@direct.sw.org

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
I20160930001930 TX Practitioner - Internal Medicine 7012215254 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of North Texas HSC, College of Osteopathic Med, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

3500 Gaston Ave
FL 1
Dallas, TX 75246-2017
Phone (972) 817-6100

4001 Worth St
Dallas, TX 75246-1608

Hospital & facility affiliations

  • Baylor University Medical Center Hospital, Dallas, TX, CCN 450021

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q7975TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network Internal Medicine CurrentSince Nov 1, 2018 Accepting new patients
Healthtexas Provider Network CurrentSince Nov 1, 2018 Accepting new patients
Baylor University Medical Center Past Accepting new patients

Locations

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

3600 Gaston Ave
Ste 558
Dallas, TX 75246

3600 Gaston Ave
Ste 550
Dallas, TX 75246
Phone (214) 821-1177

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

700 Walter Reed Blvd
Ste 203
Garland, TX 75042
Phone (972) 426-9900

Interoperability endpoints

  • Direct secure messaging: puppuluri262411@direct.sw.org

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 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": "1367366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1710322011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 GASTON AVE",
            "address_2": "WADLEY SUITE 550",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 GASTON AVE",
            "address_2": "WADLEY SUITE 550",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461800",
            "telephone_number": "214-821-1177",
            "fax_number": "214-821-1193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPPULURI",
        "first_name": "PRABHAT",
        "middle_name": "V S",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-01",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "Q7975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "puppuluri262411@direct.sw.org",
            "affiliation": "N",
            "address_1": "3600 Gaston Ave",
            "address_2": "Wadley Suite 550",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752461800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.