NPIMap

Individual provider Active NPI

Rahul Boinpally, MD

  • Family Medicine Physician
  • Fort Stockton, TX
National Provider Identifier
1891920997
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
P2832 Issued in TX
Practice address
700 N Main St
Fort Stockton, TX 79735-5626
Phone
(432) 336-8110
Fax
(833) 415-1031
NPI assigned
May 19, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X P2832 TX Primary

Addresses

Primary practice location

700 N Main St
Fort Stockton, TX 79735-5626

Mailing address

700 N Main St
Fort Stockton, TX 79735-5626
Phone (432) 336-8110

Other identifiers 4

IdentifierTypeStateIssuer
313120301MedicaidTX
1962663740MedicaidTX
1891920997MedicaidTX
P2832OtherTXTX LICENSE NO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130206000535 TX Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 3476707035 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Obstetrics/Gynecology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cactus Health Services IncGroup PAC ID 8123932308, 4 clinicians

Practice addresses (Care Compare)

700 N Main St
Fort Stockton, TX 79735-5626
Phone (432) 336-8110

Hospital & facility affiliations

  • Pecos County Memorial Hospital Hospital, Fort Stockton, TX, CCN 451389
  • Medical Center Hospital Hospital, Odessa, TX, CCN 450132

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cactus Health Services, Inc CurrentSince Dec 1, 2022 Accepting new patients
Pecos County Memorial Hospital Family Medicine CurrentSince Jan 1, 2013 Accepting new patients
Pecos County Memorial Hospital CurrentSince Jan 1, 2013 Accepting new patients

Locations

387 W Interstate 10
Fort Stockton, TX 79735
Phone (432) 336-2004

511 N Main St
Fort Stockton, TX 79735
Phone (432) 336-2291

700 N Main St
Fort Stockton, TX 79735
Phone (432) 336-8110

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Fort Stockton ClinicFort Stockton, TX, CCN 671821 Federally qualified health center Corporate Director Dec 5, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1242691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1891920997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 N MAIN ST",
            "city": "FORT STOCKTON",
            "state": "TX",
            "postal_code": "797355626",
            "telephone_number": "432-336-8110",
            "fax_number": "833-415-1031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 N MAIN ST",
            "city": "FORT STOCKTON",
            "state": "TX",
            "postal_code": "797355626",
            "telephone_number": "432-336-8110",
            "fax_number": "833-415-1031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOINPALLY",
        "first_name": "RAHUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-19",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P2832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "313120301",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962663740",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891920997",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX LICENSE NO",
            "identifier": "P2832",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Stockton, TX

Sources for this page

Verify at the official NPI Registry.