NPIMap

Organization Active NPI

360 Cardiac Care PC

  • Interventional Cardiology Physician
  • North Richland Hills, TX
National Provider Identifier
1801555784
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
Legal business name
360 CARDIAC CARE PC
Practice address
4375 Booth Calloway Rd Ste 210
North Richland Hills, TX 76180-8362
Phone
(817) 678-5988
Fax
(817) 693-1037
NPI assigned
Dec 8, 2021
Last updated
Dec 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Authorized official

Name
Dr. Sanjayanth Chamakura, MDNPI 1659368728
Title
Owner
Phone
(917) 334-7534

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
Interventional Cardiology Physician 207RI0011X NU Primary

Addresses

Primary practice location

4375 Booth Calloway Rd Ste 210
North Richland Hills, TX 76180-8362

Mailing address

517 Boulder Dr
Southlake, TX 76092-3719
Phone (917) 334-7534

Other names 1

  • 360 Cardiac Care PC Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220331002254 TX Part B Supplier - Clinic/Group Practice 7012303985 Receives reassigned benefits from 4 practitioners
Practice locations: North Richland Hills, TX; Keller, TX

National Provider Directory

National Provider Directory

Locations

1866 Keller Pkwy
Ste B
Keller, TX 76248
Phone (682) 337-3810

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DCIGCD

Practitioners & affiliated clinicians

Practitioners 4

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": "1638921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638921600000",
    "number": "1801555784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 BOULDER DR",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760923719",
            "telephone_number": "917-334-7534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4375 BOOTH CALLOWAY RD STE 210",
            "city": "NORTH RICHLAND HILLS",
            "state": "TX",
            "postal_code": "761808362",
            "telephone_number": "817-678-5988",
            "fax_number": "817-693-1037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "360 CARDIAC CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-08",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A",
        "authorized_official_last_name": "CHAMAKURA",
        "authorized_official_first_name": "SANJAYANTH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-334-7534",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "360 Cardiac Care PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in North Richland Hills, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.