Individual provider Active NPI

Sugandha Kirankumar Bhosrekar, MD

  • Psychiatry Physician
  • San Antonio, TX
National Provider Identifier
1891100632
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
U6687 Issued in TX
Practice address
17720 Corporate Woods Dr
San Antonio, TX 78259-3500
Phone
(210) 616-6406
Fax
(888) 371-0337
NPI assigned
Jun 30, 2014
Last updated
Feb 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X U6687 TX Primary

Addresses

Primary practice location

17720 Corporate Woods Dr
San Antonio, TX 78259-3500

Mailing address

PO Box 591790
San Antonio, TX 78259-0139
Phone (573) 307-0500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220414000738 AZ Practitioner - Psychiatry 6204134000 Reassigns benefits to 1 organization
I20231121003441 TX Practitioner - Psychiatry 6204134000 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2004
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

17720 Corporate Woods Dr
San Antonio, TX 78259-3500
Phone (210) 616-6406

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc CurrentSince May 1, 2022 Accepting new patients
District Medical Group, Inc CurrentSince May 1, 2022 Accepting new patients
Deshpande Healthcare LLC Psychiatry CurrentSince Oct 12, 2023 Accepting new patients
District Medical Group, Inc Current Accepting new patients
Texas Laurel Ridge Hospital LP Past Accepting new patients

Locations

570 W Brown Rd
Mesa, AZ 85201
Phone (480) 344-2000

2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043

5102 W Campbell Ave
Phoenix, AZ 85031
Phone (623) 848-5000

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

17720 Corporate Woods Dr
San Antonio, TX 78259
Phone (210) 491-9400

Interoperability endpoints

  • Direct secure messaging: sbhosrekar241447@direct.valleywisehealth.org

Organizations & group practices 5

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": "1404086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1891100632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 591790",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782590139",
            "telephone_number": "573-307-0500",
            "fax_number": "888-371-0337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17720 CORPORATE WOODS DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782593500",
            "telephone_number": "210-616-6406",
            "fax_number": "888-371-0337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHOSREKAR",
        "first_name": "SUGANDHA",
        "middle_name": "KIRANKUMAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-30",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "U6687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.