Individual provider Active NPI

Rachel Gnanaprakasam

  • Infectious Disease Physician
  • Bedford, TX
National Provider Identifier
1891272027
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
U4514 Issued in TX
Practice address
2636 Tibbets Dr Ste 110
Bedford, TX 76022-6919
Phone
(817) 858-0065
NPI assigned
Jul 20, 2018
Last updated
Sep 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X U4514 TX Primary

Addresses

Primary practice location

2636 Tibbets Dr Ste 110
Bedford, TX 76022-6919

Mailing address

2636 Tibbets Dr Ste 110
Bedford, TX 76022-6919

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
I20241012000371 TX Practitioner - Infectious Disease 9830621028 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infectious Disease Doctors, PAGroup PAC ID 1557345774, 17 clinicians

Practice addresses (Care Compare)

2636 Tibbets Dr
Suite 110
Bedford, TX 76022-6919
Phone (817) 585-0065

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
U4514TXMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
I.D. Doctors Pharmacy Current Accepting new patients
Infectious Disease Doctors, PA Infectious Disease CurrentSince Jul 25, 2024 Accepting new patients

Locations

2636 Tibbets Dr
Ste 110
Bedford, TX 76022
Phone (817) 585-0065

2300 Marie Curie Dr
Garland, TX 75042
Phone (972) 487-5000

4401 Booth Calloway Rd
Richland Hls, TX 76180
Phone (817) 255-1000

2850 E Highway 114
Trophy Club, TX 76262
Phone (817) 837-4600

Interoperability endpoints

  • Direct secure messaging: rgnanaprakasam@iddoctors.ssdirect.aprima.com

Organizations & group practices 2

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 5

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": "1532044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1891272027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2636 TIBBETS DR STE 110",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760226919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2636 TIBBETS DR STE 110",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760226919",
            "telephone_number": "817-858-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GNANAPRAKASAM",
        "first_name": "RACHEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-20",
        "last_updated": "2023-09-29",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "TX",
            "license": "U4514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, TX

Sources for this page

Verify at the official NPI Registry.