NPIMap

Individual provider Active NPI

Srinivas G. Rangu, M.D.

  • Internal Medicine Physician
  • Longview, TX
National Provider Identifier
1902963655
Registry record updated Nov 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
L1181 Issued in TX
Practice address
707 Hollybrook Dr
Longview, TX 75605-2410
Phone
(903) 291-6161
Fax
(903) 291-6159
NPI assigned
Jan 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X L1181 TX Primary

Addresses

Primary practice location

707 Hollybrook Dr
Longview, TX 75605-2410

Mailing address

PO Box 847176
Dallas, TX 75284-7176
Phone (903) 237-1800

Other identifiers 1

IdentifierTypeStateIssuer
042203202MedicaidTX

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
I20100330001158 TX Practitioner - Internal Medicine 4486780392 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Associated Clinicians of East TexasGroup PAC ID 4789957440, 106 clinicians

Practice addresses (Care Compare)

707 Hollybrook Dr
Longview, TX 75605-2410
Phone (903) 757-6042

Hospital & facility affiliations

  • Onesource Home Care Inc Home health agency, Longview, TX, CCN 679138
  • Accentcare Home Health of Texas Home health agency, Longview, TX, CCN 679090
  • Premier Home Care Home health agency, Longview, TX, CCN 743174
  • Elite Home Health Home health agency, Longview, TX, CCN 453182
  • Prime Care Hospice LLC Hospice, Longview, TX, CCN 741756
  • Longview Regional Medical Center Hospital, Longview, TX, CCN 450702
  • Christus Good Shepherd Medical Center Hospital, Longview, TX, CCN 450032

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L1181TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Clinics of Longview Internal Medicine CurrentSince Mar 5, 2012 Accepting new patients
Associated Clinicians of East Texas Internal Medicine CurrentSince Sep 1, 2017 Accepting new patients
Internal Medicine Association of Longview Internal Medicine Current Accepting new patients
Associated Clinicians of East Texas Past Accepting new patients
Diagnostic Clinic of Longview PA Internal Medicine Past Accepting new patients

Locations

707 Hollybrook Dr
Ste 504
Longview, TX 75605
Phone (903) 232-8501

703 E Marshall Ave
Ste 1001
Longview, TX 75601
Phone (903) 753-7291

1009 N 4th St
Ste A
Longview, TX 75601
Phone (903) 757-3808

707 Hollybrook Dr
Ste 500
Longview, TX 75605
Phone (903) 232-8276

707 Hollybrook Dr
Longview, TX 75605
Phone (903) 232-8501

Interoperability endpoints

  • Direct secure messaging: srinivas.rangu.1@23550.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/23550/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353974400000",
    "number": "1902963655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 847176",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752847176",
            "telephone_number": "903-237-1800",
            "fax_number": "903-237-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 HOLLYBROOK DR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756052410",
            "telephone_number": "903-291-6161",
            "fax_number": "903-291-6159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANGU",
        "first_name": "SRINIVAS",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2012-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L1181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "042203202",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.