NPIMap

Organization Active NPI

Keshavjivandas Syp, PLLC

Doing business as Interventional Pain and Spine of Greater DFW

  • Pain Clinic/Center
  • Burleson, TX
National Provider Identifier
1710514815
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
Legal business name
KESHAVJIVANDAS SYP, PLLC
Doing business as
Interventional Pain and Spine of Greater DFW
Practice address
12332 Bear PLZ Ste 100
Burleson, TX 76028-0283
Phone
(817) 615-8840
Fax
(682) 285-2468
NPI assigned
Mar 26, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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

Authorized official

Name
Mrs. Aisha Patel, MBA
Title
Office Manager
Phone
(201) 214-0730

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Clinic/Center 261QP3300X Primary

Addresses

Primary practice location

12332 Bear PLZ Ste 100
Burleson, TX 76028-0283

Mailing address

6735 Plaza Via
Irving, TX 75039-3224
Phone (501) 247-6003

Other names 1

  • Interventional Pain and Spine of Greater DFW Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200915000325 TX Part B Supplier - Clinic/Group Practice 2961820584 Receives reassigned benefits from 2 practitioners
Practice locations: Burleson, TX; Arlington, TX

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Keshavjivandas Syp PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

12332 Bear Plz
Burleson, TX 76028

121 NW Newton Dr
Burleson, TX 76028
Phone (817) 615-8840

225 Matlage Way
Unit 1207
Sugar Land, TX 77487

Practitioners & affiliated clinicians

Practitioners 4

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": "1585180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619136000000",
    "number": "1710514815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6735 PLAZA VIA",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750393224",
            "telephone_number": "501-247-6003",
            "fax_number": "682-285-2468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12332 BEAR PLZ STE 100",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760280283",
            "telephone_number": "817-615-8840",
            "fax_number": "682-285-2468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KESHAVJIVANDAS SYP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-26",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "AISHA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "201-214-0730",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Interventional Pain and Spine of Greater DFW",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Interventional Pain and Spine of Greater DFW",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burleson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2021; 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.