NPIMap

Individual provider Active NPI

Mark Gajjar, MD

  • Interventional Cardiology Physician
  • Kyle, TX
National Provider Identifier
1942519319
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
R9755 Issued in TX
Practice address
1180 Seton Pkwy Ste 450
Kyle, TX 78640-6178
Phone
(512) 504-0860
Fax
(512) 504-0861
NPI assigned
Oct 1, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125-058132 IL
Cardiovascular Disease Physician 207RC0000X R9755 TX
Interventional Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0011X R9755 TX Primary

Addresses

Primary practice location

1180 Seton Pkwy Ste 450
Kyle, TX 78640-6178

Mailing address

1180 Seton Pkwy Ste 450
Kyle, TX 78640-6178
Phone (512) 504-0860

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
I20190516000063 TX Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Pain Management 7810270543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Seton Family of DoctorsGroup PAC ID 0941333280, 785 clinicians

Practice addresses (Care Compare)

1180 Seton Pkwy
Suite 450
Kyle, TX 78640-6178
Phone (512) 504-0860

Hospital & facility affiliations

  • Ascension Seton Hays Hospital, Kyle, TX, CCN 670056
  • Ascension Seton Medical Center Austin Hospital, Austin, TX, CCN 450056
  • Guadalupe Regional Medical Center Hospital, Seguin, TX, CCN 450104
  • Christus Santa Rosa Hospital-San Marcos Hospital, San Marcos, TX, CCN 450272
  • Memorial Hospital Hospital, Gonzales, TX, CCN 450235

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125-058132ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Seton Family of Doctors Multi-Specialty CurrentSince May 6, 2019 Accepting new patients
Seton Family of Doctors CurrentSince May 6, 2019 Accepting new patients

Locations

1400 N Interstate 35
Ste 300
Austin, TX 78701
Phone (512) 324-8300

1301 W 38th St
Ste 400
Austin, TX 78705
Phone (512) 324-3340

1180 Seton Pkwy
Ste 450
Kyle, TX 78640
Phone (512) 504-0860

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

130 Hays St
Ste A
Luling, TX 78648
Phone (512) 443-5988

Interoperability endpoints

  • Direct secure messaging: mark.gajjar.1@8363.direct.athenahealth.com

Organizations & group practices 2

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 8

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": "1285891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1942519319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 SETON PKWY STE 450",
            "city": "KYLE",
            "state": "TX",
            "postal_code": "786406178",
            "telephone_number": "512-504-0860",
            "fax_number": "512-504-0861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 SETON PKWY STE 450",
            "city": "KYLE",
            "state": "TX",
            "postal_code": "786406178",
            "telephone_number": "512-504-0860",
            "fax_number": "512-504-0861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAJJAR",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-01",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125-058132",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "R9755",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "R9755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kyle, TX

Sources for this page

Verify at the official NPI Registry.