NPIMap

Organization Active NPI

Ajay Aggarwal

  • Physical Medicine & Rehabilitation Physician
  • Lake Jackson, TX
National Provider Identifier
1730628116
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
AJAY AGGARWAL
Practice address
208 Oak Dr S Ste 500
Lake Jackson, TX 77566-5789
Phone
(979) 245-7246
Fax
(979) 245-2415
NPI assigned
Feb 17, 2017
Last updated
Nov 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Authorized official

Name
Ajay Aggarwal, MDNPI 1467413567
Title
Owner/Provider
Phone
(979) 245-7246

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 6

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

208 Oak Dr S Ste 500
Lake Jackson, TX 77566-5789

Mailing address

1002 Alkire Lake Dr
Sugar Land, TX 77478-3408
Phone (979) 245-7246

Other practice location 1

5909 West Loop S Ste 310
Bellaire, TX 77401-2433
Phone (346) 610-3235

Other practice location 2

170 4th Street N
Ste. 1
Van Vleck, TX 77482
Phone (979) 245-7246

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170607000814 TX Part B Supplier - Clinic/Group Practice 8224313986 Receives reassigned benefits from 3 practitioners
Practice locations: Lake Jackson, TX; Sugar Land, TX; Van Vleck, 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
Ajay Aggarwal3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

103 Circle Way St
Ste B
Lake Jackson, TX 77566

3023 Marina Bay Dr
League City, TX 77573
Phone (281) 549-6404

170 4th St S
Ste 1
Van Vleck, TX 77482
Phone (979) 245-7246

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1487289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731542400000",
    "number": "1730628116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 ALKIRE LAKE DR",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774783408",
            "telephone_number": "979-245-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 OAK DR S STE 500",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665789",
            "telephone_number": "979-245-7246",
            "fax_number": "979-245-2415"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5909 West Loop S Ste 310",
            "address_purpose": "LOCATION",
            "city": "Bellaire",
            "state": "TX",
            "postal_code": "774012433",
            "country_code": "US",
            "telephone_number": "346-610-3235",
            "fax_number": "832-767-6908",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "170 4th Street N",
            "address_2": "Ste. 1",
            "address_purpose": "LOCATION",
            "city": "Van Vleck",
            "state": "TX",
            "postal_code": "77482",
            "country_code": "US",
            "telephone_number": "979-245-7246",
            "fax_number": "979-245-2415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AJAY AGGARWAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-17",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-12",
        "status": "A",
        "authorized_official_last_name": "AGGARWAL",
        "authorized_official_first_name": "AJAY",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "979-245-7246",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Jackson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; 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.