Individual provider Active NPI

Kayvan Kamali, M.D.

  • Rheumatology Physician
  • Longview, TX
National Provider Identifier
1013912856
Registry record updated Dec 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
L7279 Issued in TX
Practice address
920 Judson Rd
Longview, TX 75601-5113
Phone
(903) 236-7020
Fax
(903) 236-7093
NPI assigned
Jun 17, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X L7279 TX Primary

Addresses

Primary practice location

920 Judson Rd
Longview, TX 75601-5113

Mailing address

920 Judson Rd
Longview, TX 75601-5113
Phone (903) 236-7020

Other identifiers 1

IdentifierTypeStateIssuer
170428001MedicaidTX

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040512000120 TX Practitioner - Rheumatology 0446249544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rheumatology Association of Longview, PLLCGroup PAC ID 0345224614, 2 clinicians

Practice addresses (Care Compare)

920 Judson Rd
Longview, TX 75601-5113
Phone (903) 236-7020

Hospital & facility affiliations

  • Ut Health East Texas Pittsburg Hospital Hospital, Pittsburg, TX, CCN 451367
  • Titus Regional Medical Center Hospital, Mount Pleasant, TX, CCN 450080
  • Ut Health East Texas Carthage Hospital Hospital, Carthage, TX, CCN 450210
  • Christus Good Shepherd Medical Center Hospital, Longview, TX, CCN 450032
  • Ut Health East Texas Henderson Hospital Hospital, Henderson, TX, CCN 450475

Merit-based Incentive Payment System (MIPS)

Final score
85.86 of 100Reported as group
Quality
64.71
Improvement activities
40
Cost
90.2

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
L7279TXMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rheumatology Association of Longview, PLLC Rheumatology CurrentSince Mar 1, 2004 Accepting new patients
Radiology Associates of South Florida LLC Past Accepting new patients
Lafayette Clinic, PA Rheumatology Past Accepting new patients

Locations

701 E Marshall Ave
#405
Longview, TX 75601
Phone (903) 236-2719

920 Judson Rd
Longview, TX 75601
Phone (305) 363-3286

701 E Marshall Ave
Ste 405
Longview, TX 75601
Phone (903) 236-2719

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1013912856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 JUDSON RD",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015113",
            "telephone_number": "903-236-7020",
            "fax_number": "903-236-7093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 JUDSON RD",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015113",
            "telephone_number": "903-236-7020",
            "fax_number": "903-236-7093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMALI",
        "first_name": "KAYVAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "TX",
            "license": "L7279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170428001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.