Individual provider Active NPI

Amit Jairaj Mulchandani, MD

  • Family Medicine Physician
  • Prosper, TX
National Provider Identifier
1982992715
Registry record updated Dec 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-134188 Issued in IL
Practice address
111 S Preston Rd Ste 10
Prosper, TX 75078-8885
Phone
(469) 800-5200
NPI assigned
Jul 14, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-134188 IL Primary

Addresses

Primary practice location

111 S Preston Rd Ste 10
Prosper, TX 75078-8885

Mailing address

111 S Preston Rd Ste 10
Prosper, TX 75078-8885
Phone (469) 800-5200

Other practice location 1

610 S Maple Ave
Suite 2500
Oak Park, IL 60304-1091
Phone (708) 660-2900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221111002047 TX Practitioner - Family Practice 2062636756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

4001 Worth St
Dallas, TX 75246-1608

5701 Virginia Pkwy
McKinney, TX 75071-5652
Phone (214) 592-0212

821 N Coleman St
Suite 100
Prosper, TX 75078-2339
Phone (469) 800-5200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Dec 19, 2022 Accepting new patients
Healthtexas Provider Network Family Medicine Current Accepting new patients
Healthtexas Provider Network Family Medicine CurrentSince Dec 19, 2022 Accepting new patients

Locations

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

301 N Washington Ave
Fl 5
Dallas, TX 75246
Phone (469) 800-8742

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

111 S Preston Rd
Ste 10
Prosper, TX 75078
Phone (469) 800-5200

Interoperability endpoints

  • Direct secure messaging: amulchandani98650@direct.rush.rush-health.com
  • Direct secure messaging: amulchandani1114579@direct.sw.org

Organizations & group practices 4

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 4

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": "1310601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1982992715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S PRESTON RD STE 10",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750788885",
            "telephone_number": "469-800-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S PRESTON RD STE 10",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750788885",
            "telephone_number": "469-800-5200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "610 S Maple Ave",
            "address_2": "SUITE 2500",
            "address_purpose": "LOCATION",
            "city": "Oak Park",
            "state": "IL",
            "postal_code": "603041091",
            "country_code": "US",
            "telephone_number": "708-660-2900",
            "fax_number": "708-660-2901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULCHANDANI",
        "first_name": "AMIT",
        "middle_name": "JAIRAJ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-14",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-134188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prosper, TX

Sources for this page

Verify at the official NPI Registry.