Individual provider Active NPI

Selwyn Erapuram, DO

  • Emergency Medicine Physician
  • Sulphur Springs, TX
National Provider Identifier
1891256095
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
T7547 Issued in TX
Practice address
115 Airport Rd
Sulphur Springs, TX 75482-2105
Phone
(903) 885-7671
NPI assigned
Mar 29, 2019
Last updated
Sep 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X T7547 TX Primary

Addresses

Primary practice location

115 Airport Rd
Sulphur Springs, TX 75482-2105

Mailing address

115 Airport Rd
Sulphur Springs, TX 75482-2105
Phone (903) 885-7671

Other practice location 1

1541 Kings Highway
Emergency Medicine
Shreveport, LA 71130-3932
Phone (318) 626-2326

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
I20220912003684 TX Practitioner - Emergency Medicine 8729316674 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Texas Emergency Physicians PLLCGroup PAC ID 8527420306, 195 clinicians

Practice addresses (Care Compare)

719 W Coke Rd
Winnsboro, TX 75494-3011
Phone (903) 342-5227

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mother Frances Hospital Regional Health Care Center CurrentSince Aug 1, 2022 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Aug 1, 2022 Accepting new patients
Mother Frances Hospital Jacksonville CurrentSince Aug 1, 2022 Accepting new patients
Northeast Texas Emergency Physicians, PLLC Emergency Medicine CurrentSince Oct 1, 2023 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Aug 1, 2022 Accepting new patients

Locations

1007 S William St
Atlanta, TX 75551
Phone (903) 614-2000

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

115 Airport Rd
Sulphur Springs, TX 75482
Phone (903) 885-7671

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

719 W Coke Rd
Winnsboro, TX 75494
Phone (903) 342-3961

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1891256095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 AIRPORT RD",
            "city": "SULPHUR SPRINGS",
            "state": "TX",
            "postal_code": "754822105",
            "telephone_number": "903-885-7671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 AIRPORT RD",
            "city": "SULPHUR SPRINGS",
            "state": "TX",
            "postal_code": "754822105",
            "telephone_number": "903-885-7671"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1541 Kings Highway",
            "address_2": "Emergency Medicine",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711303932",
            "country_code": "US",
            "telephone_number": "318-626-2326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERAPURAM",
        "first_name": "SELWYN",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-29",
        "last_updated": "2022-09-19",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "T7547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sulphur Springs, TX

Sources for this page

Verify at the official NPI Registry.