Individual provider Active NPI

Saravanaraja Muthusamy, MD

  • Orthopaedic Surgery Physician
  • Laredo, TX
National Provider Identifier
1770864399
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
S1871 Issued in TX
Practice address
10710 McPherson Rd Ste 301
Laredo, TX 78045-6271
Phone
(956) 462-1991
NPI assigned
Sep 9, 2011
Last updated
Mar 13, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X S1871 TX
Orthopaedic Trauma Physician 207XX0801X S1871 TX
Orthopaedic Surgery Physician 207X00000X S1871 TX Primary

Addresses

Primary practice location

10710 McPherson Rd Ste 301
Laredo, TX 78045-6271

Mailing address

10710 McPherson Rd Ste 301
Laredo, TX 78045-6271
Phone (956) 462-1991

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
I20191001001168 TX Practitioner - Orthopedic SurgeryPractitioner - General Surgery 0042481145

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S1871TXMDAdult Reconstructive Orthopaedic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1315526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1770864399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10710 MCPHERSON RD STE 301",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780456271",
            "telephone_number": "956-462-1991",
            "fax_number": "956-252-2213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10710 MCPHERSON RD STE 301",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780456271",
            "telephone_number": "956-462-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTHUSAMY",
        "first_name": "SARAVANARAJA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-09",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "TX",
            "license": "S1871",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "TX",
            "license": "S1871",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "S1871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

Verify at the official NPI Registry.