Nomita Jairaj Kim, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

L2561 Issued in TX

Practice address

4303 Victory Drive
Austin, TX 78704-7507

Phone

(512) 462-3627

Fax

(512) 462-3431

NPI assigned

Dec 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Nomita Jairaj Pothuluri Former name

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

Family Practice

Education

University of Arkansas College of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Privia Medical Group Gulf Coast PLLCGroup PAC ID 4688999022, 511 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• TX HMO
• TX HMO D-SNP

Interoperability endpoints

• Direct secure messaging: nomita.kim.1@8042.direct.athenahealth.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.

• Privia Medical Group Gulf Coast, PLLC

  • Obstetrics & Gynecology Physician
  • Houston, TX
  • NPI 1578969465
  Medicare reassignment Care Compare group NPD
• Privia Medical Group Gulf Coast PLLC

  • Interventional Pain Medicine Physician
  • San Antonio, TX
  • NPI 1457167033
  NPD
• Epione Health Group PLLC

  • Surgery Physician
  • Kingwood, TX
  • NPI 1609068493
  NPD (past)

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

{
    "created_epoch": "1166313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1013070754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4303 VICTORY DRIVE",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787047507",
            "telephone_number": "512-462-3627",
            "fax_number": "512-462-3431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4303 VICTORY DRIVE",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787047507",
            "telephone_number": "512-462-3627",
            "fax_number": "512-462-3431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "NOMITA",
        "middle_name": "JAIRAJ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-17",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L2561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146358001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NOMITA",
            "last_name": "POTHULURI",
            "middle_name": "JAIRAJ",
            "credential": "NOMITA POTHULURI, MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jung Kim
• Kyung Hee Kim, LMSW
• Margaret Kim
• Michelle Kim, DDS
• Minji Kim
• Phillip Kim
• Ronald S. Kim, MD
• Sarah Kim, PHARM D
• Seo Hee Kim, DO
• Sinil Kim, M.D.

• Family Medicine Physician in Austin, TX
• Providers in Austin, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.