Individual provider Active NPI

Surya Prakash Raguthu, M.D.,

  • Physical Medicine & Rehabilitation Physician
  • Brownsville, TX
National Provider Identifier
1720125412
Registry record updated Mar 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
L9857 Issued in TX
Practice address
315 Jose Marti Blvd
Brownsville, TX 78526-2868
Phone
(956) 546-7530
Fax
(956) 546-7531
NPI assigned
Jan 31, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X L9857 TX Primary

Addresses

Primary practice location

315 Jose Marti Blvd
Brownsville, TX 78526-2868

Mailing address

PO Box 5386
Brownsville, TX 78523-5386
Phone (956) 546-7530

Other identifiers 1

IdentifierTypeStateIssuer
L9857OtherTXTX LICENSE

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
I20050517000267 TX Practitioner - Physical Medicine and RehabilitationPractitioner - Internal MedicinePractitioner - Pain Management 6608817010 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Pain Management
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

315 Jose Marti Blvd
Brownsville, TX 78526-2868
Phone (956) 546-7530

Hospital & facility affiliations

  • Houston Methodist Sugarland Hospital Hospital, Sugar Land, TX, CCN 450820

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L9857TXMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ace Pain Management Rehab & Physical Therapy PLLC CurrentSince Apr 25, 2012 Accepting new patients
Medwin Family Medicine & Rehabilitation PC CurrentSince Aug 1, 2002 Accepting new patients
Qazi K. Haider, MD, PC Past Accepting new patients
Wyckoff Medical Services, P C Past Accepting new patients

Locations

315 Jose Marti Blvd
Brownsville, TX 78526
Phone (956) 546-7530

425 E Alton Gloor Blvd
Brownsville, TX 78526
Phone (956) 554-6000

1235 Lake Pointe Pkwy
Ste 103
Sugar Land, TX 77478
Phone (832) 532-0040

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": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267401600000",
    "number": "1720125412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5386",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785235386",
            "telephone_number": "956-546-7530",
            "fax_number": "956-546-7531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 JOSE MARTI BLVD",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785262868",
            "telephone_number": "956-546-7530",
            "fax_number": "956-546-7531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGUTHU",
        "first_name": "SURYA",
        "middle_name": "PRAKASH",
        "name_prefix": "Dr.",
        "credential": "M.D.,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2010-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "L9857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX LICENSE",
            "identifier": "L9857",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownsville, TX

Sources for this page

Verify at the official NPI Registry.