Individual provider Active NPI

Radhika E. Ravula, MD

  • Pain Medicine (Anesthesiology) Physician
  • Plano, TX
National Provider Identifier
1750368445
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
K8450 Issued in TX
Practice address
4708 Alliance Blvd Ste 850
Plano, TX 75093-5343
Phone
(469) 814-5960
NPI assigned
Dec 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X K8450 TX
Pain Medicine (Psychiatry & Neurology) Physician 2084P2900X K8450 TX
Pain Medicine (Anesthesiology) Physician 207LP2900X K8450 TX Primary

Addresses

Primary practice location

4708 Alliance Blvd Ste 850
Plano, TX 75093-5343

Mailing address

4708 Alliance Blvd
Ste 850
Plano, TX 75093-5343
Phone (469) 814-5960

Other identifiers 5

IdentifierTypeStateIssuer
101180103MedicaidTX
101180104MedicaidTX
101180105MedicaidTX
8G2125OtherTXBLUE CROSS BLUE SHIELD
720000337OtherTXRAILROAD

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
I20091207000458 TX Practitioner - Pain ManagementPractitioner - Anesthesiology 9537174479 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4708 Alliance Blvd
Suite 850
Plano, TX 75093-5343
Phone (469) 814-5960

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K8450TXMDPain Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sterling Pain Medicine, P.a. Pain Medicine CurrentSince Feb 6, 2011 Accepting new patients
Anesthesia Consultants of Dallas, LLP Anesthesiology Past Accepting new patients
Anesthesia Consultants of Dallas LLP Anesthesiology Past Accepting new patients

Locations

11700 Preston Rd
Ste 660
Dallas, TX 75230
Phone (469) 420-5205

11700 Preston Rd
Ste 660529
Dallas, TX 75230

4708 Alliance Blvd
Ste 810
Plano, TX 75093
Phone (469) 814-5960

4708 Alliance Blvd
Ste 850
Plano, TX 75093
Phone (469) 814-5960

2520 N Central Expy
Ste 400
Richardson, TX 75080
Phone (972) 231-1591

600 Cooper Dr
Ste 100
Wylie, TX 75098
Phone (972) 231-1591

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AIJFCD/Endpoint/AIJFCD
  • Direct secure messaging: dmcrravul@yourcarecommunity.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 4

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": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1750368445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4708 ALLIANCE BLVD",
            "address_2": "STE 850",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935343",
            "telephone_number": "469-814-5960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4708 ALLIANCE BLVD STE 850",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935343",
            "telephone_number": "469-814-5960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVULA",
        "first_name": "RADHIKA",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-23",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "K8450",
            "primary": false
        },
        {
            "code": "2084P2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": "TX",
            "license": "K8450",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "TX",
            "license": "K8450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101180103",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101180104",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101180105",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8G2125",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "720000337",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.