Organization Active NPI

Atlas OB-GYN, PLLC

  • Obstetrics & Gynecology Physician
  • Richardson, TX
National Provider Identifier
1962962423
Registry record updated Oct 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
ATLAS OB-GYN, PLLC
Practice address
2821 E President George Bush Hwy Ste 207
Richardson, TX 75082-4277
Phone
(972) 907-1280
Fax
(972) 907-1290
NPI assigned
Mar 21, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2022

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

Authorized official

Name
Dr. Mini Sreedevi, MDNPI 1184930331
Title
Physician/Owner
Phone
(972) 907-1280

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
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

2821 E President George Bush Hwy Ste 207
Richardson, TX 75082-4277

Mailing address

2821 E President George Bush Hwy Ste 207
Richardson, TX 75082-4281
Phone (972) 907-1280

Other identifiers 1

IdentifierTypeStateIssuer
036124963MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190802001748 TX Part B Supplier - Clinic/Group Practice 7113254814 Receives reassigned benefits from 5 practitioners
Practice locations: Richardson, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2170974Atlas OB-GYN, PLLC2821 E President George Bush Hwy Suite 207, Richardson, TX 75082Certificate of waiverAug 21, 2027

National Provider Directory

National Provider Directory

Locations

2821 George Bush Hwy
Ste 207
Richardson, TX 75082
Phone (972) 907-1280

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19695/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 5

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": "1553126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667001600000",
    "number": "1962962423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2821 E PRESIDENT GEORGE BUSH HWY STE 207",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750824281",
            "telephone_number": "972-907-1280",
            "fax_number": "972-907-1290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 E PRESIDENT GEORGE BUSH HWY STE 207",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750824277",
            "telephone_number": "972-907-1280",
            "fax_number": "972-907-1290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLAS OB-GYN, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-21",
        "last_updated": "2022-10-29",
        "certification_date": "2022-10-29",
        "status": "A",
        "authorized_official_last_name": "SREEDEVI",
        "authorized_official_first_name": "MINI",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "972-907-1280",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036124963",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2022; 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.