DR. MANJUSHREE GAUTAM (NPI# 1831172725) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831172725 |
| Entity Type | Individual |
| Full Name | DR. MANJUSHREE GAUTAM |
| Credential | M.D. |
| Practice Address |
1250 8th Ave Suite 515 Fort Worth TX 76104-4124 |
| Practice Telephone | 8179224675 |
| Practice Fax Number | 8179224645 |
| Mailing Telephone | 8179224675 |
| Mailing Fax Number | 8179224645 |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2015-07-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
N6309 | TX | Allopathic & Osteopathic Physicians |
| N | 207RI0008X |
Internal Medicine Specialization: Hepatology |
33778 | AZ | Allopathic & Osteopathic Physicians |
| N | 207RT0003X |
Internal Medicine Specialization: Transplant Hepatology |
N6309 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 935554 | 05 | |
| TX | 217199301 | 05 | |
| TX | BCBSTX | 8BN847 | 01 |
| AZ | RAILROAD MEDICARE | P00278312 | 01 |
| AZ | TRIWEST | 86080015085259D008 | 01 |
| Street Address |
1250 8TH AVE SUITE 515 |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76104-4124 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942201405 | Helen Jane Bussey | Surgery | 1250 8th Ave, Suite 545, Fort Worth, TX 76104-4124 | 2005-08-09 |
| 1811597321 | Kathryn Varano | Physician Assistant | 1250 8th Ave, Fort Worth, TX 76104-4124 | 2020-10-26 |
| 1851933121 | Maegan Schwab | Advanced Practice Midwife | 1250 8th Ave, Fort Worth, TX 76104-4124 | 2019-10-08 |
| 1376995829 | Sarah A Black | Physician Assistant | 1250 8th Ave, Suite 575, Fort Worth, TX 76104-4124 | 2016-07-08 |
| 1053724591 | Akunna Ukanwoke | Nurse Practitioner | 1250 8th Ave, Suite 515, Fort Worth, TX 76104-4124 | 2014-06-03 |
| 1972880946 | Jean L. Kernal | Clinical Nurse Specialist | 1250 8th Ave, Suite 515, Fort Worth, TX 76104-4124 | 2011-11-04 |
| 1033440151 | Center for Assisted Reproduction Laboratory and Surgery Center Inc. | Clinical Medical Laboratory | 1250 8th Ave, Suite 365, Fort Worth, TX 76104-4124 | 2010-01-29 |
| 1558692665 | Center for Assisted Reproduction, Pa | Obstetrics & Gynecology | 1250 8th Ave, Suite 365, Fort Worth, TX 76104-4124 | 2010-01-29 |
| 1770813990 | Jennifer Michelle Dinubila | Nurse Practitioner | 1250 8th Ave, Ste 500, Fort Worth, TX 76104-4124 | 2010-01-11 |
| 1265663447 | John Aaron Whitfield, Md, Facog, Pa | Clinic/Center | 1250 8th Ave, Suite 540, Fort Worth, TX 76104 | 2009-08-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669082186 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1115 8th St, Fort Worth, TX 76104 | 2020-08-10 |
| 1992343693 | Iris Giove | Psychologist | John Peter Smith Hospital, 1500 S. Main St., Fort Worth, TX 76104 | 2019-12-13 |
| 1104480656 | Swarnalaxmi Umapathy | Student in an Organized Health Care Education/Training Program | 900 8th Avenue, Fort Worth, TX 76104 | 2019-04-30 |
| 1881189132 | Mega Surgical Assistants LLC | Specialist/Technologist, Other | 1301pennsylvania, Fort Worth, TX 76104 | 2018-06-28 |
| 1356848899 | Tricia Kelly | Nurse Practitioner | 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 | 2018-04-11 |
| 1952820979 | Modern Vein Clinic | Internal Medicine | 757 8th Avenue, Suite A, Forth Worth, TX 76104 | 2017-09-11 |
| 1790207165 | Vanessa Abbood | Dietitian, Registered | 900 Eighth Ave, Fns Department, Fort Worth, TX 76104 | 2017-07-07 |
| 1922537562 | Nicole Marie Tod | Student in an Organized Health Care Education/Training Program | 1500 S Main Street, Fort Worth, TX 76104 | 2017-06-07 |
| 1770025934 | Micah Bonola | Chiropractor | 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 | 2016-11-04 |
| 1518315894 | United Bioscience, LLC. | Clinical Medical Laboratory | 901 W. Leuda St., B, Fort Worth, TX 76104 | 2016-05-27 |
| Find all providers in zip 76104 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770929614 | Vikram Anand | Internal Medicine | 1350 S Main St Ste 3200, Fort Worth, TX 76104-7669 | 2013-05-20 |
| 1750655221 | Texas Health Care, Pllc | Internal Medicine | 800 8th Ave Ste 632, Fort Worth, TX 76104-2617 | 2012-03-01 |
| 1598963746 | Priya Rangasamy | Internal Medicine | 909 9th Ave Ste 205, Fort Worth, TX 76104-3916 | 2007-07-10 |
| 1306946934 | Jay Beckwith | Internal Medicine | 1051 Haskell St, 208, Fort Worth, TX 76107-2649 | 2006-09-24 |
| 1912915034 | Nataraj Kasal | Internal Medicine | 6300 Ridglea Pl Ste 1103, Fort Worth, TX 76116-5737 | 2006-08-04 |
| 1720005523 | Gastroenterology Associates of North Texas, LLP | Internal Medicine | 900 W Magnolia Ave Ste 100, Fort Worth, TX 76104-8518 | 2006-07-16 |
| 1588616205 | Shahid Aziz | Internal Medicine | 1650 W Rosedale St Ste 302, Fort Worth, TX 76104-7400 | 2006-05-17 |
| 1790745990 | Donald R Johnson | Internal Medicine | 1111 5th Ave, Fort Worth, TX 76104-4302 | 2006-03-23 |
| 1265411920 | Jeffrey L.. Krieger | Internal Medicine | 9509 N Beach St, Ste 101, Fort Worth, TX 76244-6399 | 2006-01-11 |
| 1992781330 | Pavani Muddasani | Internal Medicine | 508 S Adams St Ste 202, Fort Worth, TX 76104-2151 | 2005-12-19 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76104 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.