Organization Active NPI

North Texas Rheumatology PA

  • Rheumatology Physician
  • Dallas, TX
National Provider Identifier
1902130156
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
M2255 Issued in TX
Legal business name
NORTH TEXAS RHEUMATOLOGY PA
Practice address
8220 Walnut Hill LN Ste 414
Dallas, TX 75231-4417
Phone
(469) 916-0677
NPI assigned
Sep 21, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Pooja Banerjee, MDNPI 1538138011
Title
Owner / Director / Physician
Phone
(469) 916-0677

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RR0500X M2255 TX Primary

Addresses

Primary practice location

8220 Walnut Hill LN Ste 414
Dallas, TX 75231-4417

Mailing address

8220 Walnut Hill LN Ste 414
Dallas, TX 75231-4417
Phone (469) 916-0677

Other identifiers 1

IdentifierTypeStateIssuer
0A5838OtherGROUP MEDICARE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100316000115 TX Part B Supplier - Clinic/Group Practice 0345375499 Receives reassigned benefits from 1 practitioner
Practice locations: Dallas, TX

National Provider Directory

National Provider Directory

Locations

8230 Walnut Hill Ln
Ste 614
Dallas, TX 75231
Phone (469) 916-0677

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1253491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1902130156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8220 WALNUT HILL LN STE 414",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314417",
            "telephone_number": "469-916-0677",
            "fax_number": "214-716-5283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8220 WALNUT HILL LN STE 414",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314417",
            "telephone_number": "469-916-0677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH TEXAS RHEUMATOLOGY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-21",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BANERJEE",
        "authorized_official_first_name": "POOJA",
        "authorized_official_title_or_position": "OWNER / DIRECTOR / PHYSICIAN",
        "authorized_official_telephone_number": "469-916-0677",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "TX",
            "license": "M2255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE NUMBER",
            "identifier": "0A5838",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.