Individual provider Active NPI

Roshan Narasimha Devarakonda, PT, DPT

  • Physical Therapist
  • Houston, TX
National Provider Identifier
1912552670
Registry record updated Aug 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1321775 Issued in TX
Practice address
9055 Katy Fwy Ste 440
Houston, TX 77024-1631
Phone
(713) 464-8357
NPI assigned
Aug 8, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1321775 TX Primary

Addresses

Primary practice location

9055 Katy Fwy Ste 440
Houston, TX 77024-1631

Mailing address

9055 Katy Fwy Ste 440
Houston, TX 77024-1631
Phone (713) 464-8357

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231016003342 WA Practitioner - Physical Therapist in Private Practice 3870948581 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Manual Therapy International Professional Services PLLCGroup PAC ID 7012808041, 44 clinicians

Practice addresses (Care Compare)

1560 140TH Ave NE
Suite 100
Bellevue, WA 98005-4571
Phone (206) 746-2475

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1321775TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Manual Therapy International Professional Services PLLC Physical Therapist CurrentSince Aug 28, 2023 Accepting new patients

Locations

1560 140th Ave NE
Ste 100
Bellevue, WA 98005
Phone (425) 746-2475

3200 W McGraw St
Seattle, WA 98199
Phone (206) 281-7970

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1565222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565222400000",
    "number": "1912552670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9055 KATY FWY STE 440",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770241631",
            "telephone_number": "713-464-8357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9055 KATY FWY STE 440",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770241631",
            "telephone_number": "713-464-8357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVARAKONDA",
        "first_name": "ROSHAN",
        "middle_name": "NARASIMHA",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-08",
        "last_updated": "2019-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1321775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.