Organization Active NPI

Kumar Sathianathan, Mdpa

  • Internal Medicine Physician
  • Georgetown, TX
National Provider Identifier
1750577862
Registry record updated Sep 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
K8472 Issued in TX
Legal business name
KUMAR SATHIANATHAN, MDPA
Practice address
3613 Williams Dr Ste 404
Georgetown, TX 78628-1370
Phone
(512) 930-4275
Fax
(512) 930-4093
NPI assigned
Sep 21, 2007
Last updated
Sep 21, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2007

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

Authorized official

Name
Dr. Kumar Sathianathan, MDNPI 1831144161
Title
Owner
Phone
(512) 930-4275

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
Internal Medicine Physician 207R00000X K8472 TX Primary

Addresses

Primary practice location

3613 Williams Dr Ste 404
Georgetown, TX 78628-1370

Mailing address

3613 Williams Dr Ste 404
Georgetown, TX 78628-1370
Phone (512) 930-4275

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050801000905 TX Part B Supplier - Clinic/Group Practice 1759319684 Receives reassigned benefits from 1 practitioner
Practice locations: Georgetown, TX

National Provider Directory

National Provider Directory

Locations

3613 Williams Dr
Ste 404
Georgetown, TX 78628
Phone (512) 930-4275

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190332800000",
    "number": "1750577862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3613 WILLIAMS DR STE 404",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786281370",
            "telephone_number": "512-930-4275",
            "fax_number": "512-930-4093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3613 WILLIAMS DR STE 404",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786281370",
            "telephone_number": "512-930-4275",
            "fax_number": "512-930-4093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KUMAR SATHIANATHAN, MDPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-21",
        "last_updated": "2007-09-21",
        "status": "A",
        "authorized_official_last_name": "SATHIANATHAN",
        "authorized_official_first_name": "KUMAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-930-4275",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K8472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2007; 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.