NPIMap

Individual provider Active NPI

Sudhir R Gogu, D.O., PHD, MBA

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1942270400
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L0209 Issued in TX
Practice address
104 Gallery Circle
Suite 114
San Antonio, TX 78258-3330
Phone
(210) 481-6060
Fax
(210) 481-6068
NPI assigned
Jan 25, 2006
Last updated
May 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X L0209 TX
Family Medicine Physician 207Q00000X L0209 TX Primary

Addresses

Primary practice location

104 Gallery Circle
Suite 114
San Antonio, TX 78258-3330

Mailing address

104 Gallery Circle
Ste 114
San Antonio, TX 78258-3330
Phone (210) 481-6060

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
I20040423001104 TX Practitioner - Family PracticePractitioner - Osteopathic Manipulative MedicinePractitioner - Allergy/Immunology 5991791980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Allergy/Immunology, Osteopathic Manipulative Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

104 Gallery Cir
Suite 114
San Antonio, TX 78258-3330
Phone (210) 481-6060

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue378
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Master of Business Administration, Doctor of Medicine, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Urgent Care Center L.P Family Medicine CurrentSince Jan 1, 2007 Accepting new patients
Southern Urgent Care Center L.P Past Accepting new patients
Texas Emergency Room Services, PA Emergency Medicine Past Accepting new patients
Stone Oak Urgent Care & Family P.a. Past Accepting new patients
Socrates Emergency Physicians Emergency Medicine Past Accepting new patients
Buffalo Springs Emergency Physicians Emergency Medicine Past Accepting new patients
Step Emergency Physicians Emergency Medicine Past Accepting new patients
Hondo Emergency Physicians PLLC Emergency Medicine Past Accepting new patients
Hardy Oak Emergency Physicians PLLC Emergency Medicine Past Accepting new patients
Seminole Hospital District of Gaines County Texas Emergency Medicine Past Accepting new patients

Locations

104 Gallery Cir
Ste 114
San Antonio, TX 78258
Phone (210) 481-6060

Interoperability endpoints

  • Direct secure messaging: dr.sudhirgogu@soucfp-tx.direct.office.nextgen.com

Organizations & group practices 11

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 1

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": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1942270400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 GALLERY CIRCLE",
            "address_2": "STE 114",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583330",
            "telephone_number": "210-481-6060",
            "fax_number": "210-481-6068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 GALLERY CIRCLE",
            "address_2": "SUITE 114",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583330",
            "telephone_number": "210-481-6060",
            "fax_number": "210-481-6068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOGU",
        "first_name": "SUDHIR",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.O., PHD, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "L0209",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L0209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.