Preetham Reddy Muskula, MD

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

T4009 Issued in TX

Practice address

2608 McDonald Rd
Tyler, TX 75701-5934

Phone

(903) 595-5514

Fax

(903) 262-3715

NPI assigned

Jul 16, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Electronic endpoints 1

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

Specialty

Cardiovascular Disease (Cardiology)

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ut Health East Texas Tyler Regional Hospital Hospital, Tyler, TX, CCN 450083
• Ut Health East Texas Henderson Hospital Hospital, Henderson, TX, CCN 450475
• Ut Health East Texas Jacksonville Hospital Hospital, Jacksonville, TX, CCN 450194
• Ut Health East Texas Athens Hospital Hospital, Athens, TX, CCN 450389
• University of Texas Health Science Center at Tyler Hospital, Tyler, TX, CCN 450690
• Ut Health East Texas Rehabilitation Hospital Inpatient rehabilitation facility, Tyler, TX, CCN 453072

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pmuskula283561@ewd.direct.hshs.org
• Direct secure messaging: pmuskula576656@ahs.direct-ci.com

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.

• Etmc Physician Group Inc.

  • Cardiovascular Disease Physician
  • Tyler, TX
  • NPI 1609382662
  Medicare reassignment Care Compare group NPD
• Etmc Physician Group Inc.

  • Rural Health Clinic/Center
  • Chandler, TX
  • NPI 1235706581
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Athens Hospital, LLC

  • General Acute Care Hospital
  • Athens, TX
  • NPI 1417465824
  Care Compare affiliation
• Henderson Hospital, LLC

  • General Acute Care Hospital
  • Henderson, TX
  • NPI 1326546797
  Care Compare affiliation
• Jacksonville Hospital LLC

  • General Acute Care Hospital
  • Jacksonville, TX
  • NPI 1730697350
  Care Compare affiliation
• Rehabilitation Hospital, LLC

  • Rehabilitation Hospital
  • Tyler, TX
  • NPI 1174021695

  Inpatient rehabilitation facility

  Care Compare affiliation
• Tyler Regional Hospital LLC

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1407364847
  Care Compare affiliation
• University of Texas Health Science Center at Tyler

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1417941295
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1310774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1003104605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2608 MCDONALD RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757015934",
            "telephone_number": "903-595-5514",
            "fax_number": "903-262-3715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2608 MCDONALD RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757015934",
            "telephone_number": "903-595-5514",
            "fax_number": "903-262-3715"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "619 E Mason St Ste 4P57",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627011034",
            "country_code": "US",
            "telephone_number": "217-788-0706",
            "fax_number": "217-525-2535",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "611 W. Park St.",
            "address_purpose": "LOCATION",
            "city": "Urbana",
            "state": "IL",
            "postal_code": "618012500",
            "country_code": "US",
            "telephone_number": "217-383-3129",
            "fax_number": "217-326-1550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUSKULA",
        "first_name": "PREETHAM",
        "middle_name": "REDDY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-16",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125059036",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036135787",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036.135787",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IL",
            "license": "036.135787",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "T4009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pmuskula283561@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "619 E Mason St Ste 4P57",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627011034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• James M Muse, M.D.
• MVP Pediatric Home Health Corp
• Khotwanaeya A Mwamba, M.D.
• Johnson N Mwangi, PA-C
• Paola Mwenentanda, NP
• My Signature Nutrition, LLC

• Interventional Cardiology Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Interventional Cardiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.