Austin Kidney Care LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

AUSTIN KIDNEY CARE LLC

Practice address

2005 Palo Duro Rd
Austin, TX 78757-3242

Phone

(617) 538-2245

NPI assigned

Sep 10, 2019

Last updated

Sep 10, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Raeeda GheewalaNPI 1851507115

Title

MD

Phone

(617) 538-2245

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 1

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.

• Raeeda Munir Gheewala, MD

  • Nephrology Physician
  • Austin, TX
  • NPI 1851507115
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568073600000",
    "number": "1841849098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 PALO DURO RD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787573242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 PALO DURO RD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787573242",
            "telephone_number": "617-538-2245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUSTIN KIDNEY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-10",
        "last_updated": "2019-09-10",
        "status": "A",
        "authorized_official_last_name": "GHEEWALA",
        "authorized_official_first_name": "RAEEDA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "617-538-2245"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nephrology Physician in Austin, TX
• Providers in Austin, TX by specialty
• Nephrology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; 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.