SUSRUTHA THANAM (M.D.) – Psychiatry Physician, NPI 1174822415

SUSRUTHA THANAM (M.D.) is a healthcare provider. based in Austin, Texas. specializing in PSYCHIATRY. They hold the professional credentials M.D.. They hold a License No. Q2860 (TX). The NPI Number for SUSRUTHA THANAM (M.D.) is 1174822415

Main info

Female
25 Years Of Experience
Accepts Medicare Assignment
Name
SUSRUTHA THANAM (M.D.)
NPI
1174822415
Phone
(512) 419-2148
Address
4110 GUADALUPE ST
Enumeration Date
25 March 2011
Last Update Date
10 October 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9403815000
Graduation Year
2001 (25 years ago)
PAC ID
2668761628
Group Practice PAC ID
0547159329
Professional Enrollment ID
I20160513000955
Address ID
TX762012324DE2519XSTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:15State licenses:1Digital endpointsOther names

2,132 PSYCHIATRY in TX

Provider Addresses for SUSRUTHA THANAM (M.D.)

  • 4110 GUADALUPE ST

    AUSTIN STATE HOSPITAL

    AUSTIN, TX 787514223

    Phone: (512) 419-2148

    Fax: (512) 419-2163

    Type: Mailing

  • 2519 Scripture St

    Denton, TX 762012324

    Phone: (940) 381-5000

    Fax: (940) 566-9072

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-05-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20160513000955IPsychiatryTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 78751)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0547159329View full group profile
NameSpecialtyState
-TX
P S Y C H I A T R YTX
Mental Health CounselorTX
Nurse PractitionerTX
Nurse PractitionerTX
-SC
-TX
Nurse PractitionerTX
P S Y C H I A T R YTX
P S Y C H I A T R YTX

Reviews

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Frequently asked questions

Can I use this page to confirm SUSRUTHA THANAM (M.D.)'s NPI?
Yes. SUSRUTHA THANAM (M.D.) is listed with NPI 1174822415 in the public NPI dataset.
Does CMS list SUSRUTHA THANAM (M.D.) as active?
Yes — SUSRUTHA THANAM (M.D.) is active in the NPI listing used on this page.
What is SUSRUTHA THANAM (M.D.) best known for clinically?
Directory data describes SUSRUTHA THANAM (M.D.) with Psychiatry Physician. Clinical services aligned with this taxonomy classification.
What area does SUSRUTHA THANAM (M.D.) serve?
SUSRUTHA THANAM (M.D.)'s listing highlights Austin, Texas; more addresses can appear in NPPES.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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