Individual provider Active NPI

Melissa D Asgaonkar

  • Pediatrics Physician
  • Southlake, TX
National Provider Identifier
1861418907
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
N5540 Issued in TX
Practice address
1130 N Kimball Ave Ste 100
Southlake, TX 76092-4732
Phone
(817) 865-3564
Fax
(817) 865-3576
NPI assigned
Jul 14, 2006
Last updated
Aug 13, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X N5540 TX Primary

Addresses

Primary practice location

1130 N Kimball Ave Ste 100
Southlake, TX 76092-4732

Mailing address

PO Box 92005
Southlake, TX 76092-0101
Phone (817) 865-3564

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
N5540TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arbor Pediatrics, PLLC Pediatrics CurrentSince Aug 23, 2020 Accepting new patients
Omar a. Gomez, M.D.,P.a. Pediatrics Past Accepting new patients
Omar a. Gomez, M.D.,P.a. Pediatrics Past Accepting new patients

Locations

1130 N Kimball Ave
Ste 100
Southlake, TX 76092
Phone (817) 865-3564

Interoperability endpoints

  • Direct secure messaging: masgaonkar@arborpediatrics.opdirect.net
  • Direct secure messaging: melissa.asgaonkar.1@31361.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1861418907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 92005",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760920101",
            "telephone_number": "817-865-3564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 N KIMBALL AVE STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760924732",
            "telephone_number": "817-865-3564",
            "fax_number": "817-865-3576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASGAONKAR",
        "first_name": "MELISSA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "N5540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.