Organization Active NPI

Radha Tamerisa MD PA

  • Gastroenterology Physician
  • Katy, TX
National Provider Identifier
1730610320
Registry record updated Mar 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
L7210 Issued in TX
Legal business name
RADHA TAMERISA MD PA
Practice address
1331 W Grand Pkwy N
Suite 350
Katy, TX 77493-2710
Phone
(281) 395-8688
Fax
(281) 395-8480
NPI assigned
Mar 24, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2017

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

Authorized official

Name
Radha A Tamerisa, MDNPI 1366440653
Title
Physician/Owner
Phone
(281) 395-8688

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X L7210 TX Primary

Addresses

Primary practice location

1331 W Grand Pkwy N
Suite 350
Katy, TX 77493-2710

Mailing address

1331 W Grand Pkwy N
Suite 350
Katy, TX 77493-2710
Phone (281) 395-8688

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170608002052 TX Part B Supplier - Clinic/Group Practice 4789952060 Receives reassigned benefits from 2 practitioners
Practice locations: Katy, TX

National Provider Directory

National Provider Directory

Locations

25230 Kingsland Blvd
Ste 102
Katy, TX 77494
Phone (281) 869-3009

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DCACCD
  • FHIR API: https://api.platform.athenahealth.com/15428/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 2

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": "1490313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490313600000",
    "number": "1730610320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 W GRAND PKWY N",
            "address_2": "SUITE 350",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774932710",
            "telephone_number": "281-395-8688",
            "fax_number": "281-395-8480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 W GRAND PKWY N",
            "address_2": "SUITE 350",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774932710",
            "telephone_number": "281-395-8688",
            "fax_number": "281-395-8480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADHA TAMERISA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-24",
        "last_updated": "2017-03-24",
        "status": "A",
        "authorized_official_last_name": "TAMERISA",
        "authorized_official_first_name": "RADHA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "281-395-8688",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "L7210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2017; 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.