Kamlesh J. Sisodiya, M.D.

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

K1931 Issued in TX

Practice address

5400 State Highway 121 Ste 100
Colleyville, TX 76034-5929

Phone

(817) 479-1500

Fax

(817) 479-1504

NPI assigned

Dec 28, 2005

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

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EBJEAD/Endpoint/EBJEAD

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.

• Memorial MRI and Diagnostic LLC

  • Diagnostic Radiology Physician
  • Houston, TX
  • NPI 1912989120
  Medicare reassignment NPD
• Synaptic Solutions PLLC

  • Anesthesiology Physician
  • Hurst, TX
  • NPI 1679173876
  NPD Authorized official
• Sheridan Healthcare of North Texas PA

  • Anesthesiology Physician
  • Sunrise, FL
  • NPI 1538142088
  NPD (past)

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1003893397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 GABLES CT STE 201",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750757648",
            "telephone_number": "469-326-5115",
            "fax_number": "469-326-5119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 STATE HIGHWAY 121 STE 100",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "760345929",
            "telephone_number": "817-479-1500",
            "fax_number": "817-479-1504"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1417 Gables Ct Ste 201",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750757648",
            "country_code": "US",
            "telephone_number": "469-326-5115",
            "fax_number": "972-715-9976",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4444 Heritage Trace Pkwy Ste 408",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "762448918",
            "country_code": "US",
            "telephone_number": "817-479-1500",
            "fax_number": "512-479-1504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SISODIYA",
        "first_name": "KAMLESH",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "K1931",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "TX",
            "license": "K1931",
            "primary": false
        },
        {
            "code": "2084P2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": "TX",
            "license": "K1931",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "TX",
            "license": "K1931",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "TX",
            "license": "K1931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8EL145",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR",
            "identifier": "P01356074",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127663610",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie E Silva, LPC-ASSOCIATE
• Silver Ridge Assisted Living
• Silver Ridge Assisted Living and Alzheimer'S Care
• Janie Simmons, MD
• Taudrea Sinnie
• Siva Assisted Living Services LTD Co
• Leslie Skaggs, RN, AGNP-BC
• Skin Surgery Center, PA
• Smile Boutique of Hurst
• Allyson Smith, NP

• Interventional Pain Medicine Physician in Colleyville, TX
• Providers in Colleyville, TX by specialty
• Interventional Pain Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.