Individual provider Active NPI

Anupama Chennupati, MD

  • Infectious Disease Physician
  • Fort Worth, TX
National Provider Identifier
1023258043
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
P5523 Issued in TX
Practice address
1634 Mistletoe Blvd
Fort Worth, TX 76104-4012
Phone
(817) 818-8433
Fax
(817) 423-7473
NPI assigned
Mar 3, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X P5523 TX Primary

Addresses

Primary practice location

1634 Mistletoe Blvd
Fort Worth, TX 76104-4012

Mailing address

912 Charleston Dr
Southlake, TX 76092-1536
Phone (817) 818-8433

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
I20151002000439 TX Practitioner - Infectious DiseasePractitioner - Internal Medicine 1355483900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1634 Mistletoe Blvd
Fort Worth, TX 76104-4012
Phone (817) 818-8433

Hospital & facility affiliations

  • Amatus Health Care LLC Home health agency, Farmers Branch, TX, CCN 747682
  • Medical City Fort Worth Hospital, Fort Worth, TX, CCN 450672
  • Medical City Weatherford Hospital, Weatherford, TX, CCN 450203

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P5523TXMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Idexpertcare PA Infectious Disease CurrentSince Dec 1, 2018 Accepting new patients
Cogent Healthcare of Pennsylvania, Inc. Past Accepting new patients

Locations

11803 South Fwy
Ste 215
Burleson, TX 76028
Phone (817) 293-3000

609 Medical Center Dr
Ste 2500
Decatur, TX 76234
Phone (214) 337-6362

1634 Mistletoe Blvd
Fort Worth, TX 76104
Phone (214) 461-0543

118 Lynn Ave
Ste 100
Lewisville, TX 75057
Phone (214) 396-8877

Organizations & group practices 2

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 3

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": "1236038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1023258043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 CHARLESTON DR",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760921536",
            "telephone_number": "817-818-8433",
            "fax_number": "949-404-6343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1634 MISTLETOE BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044012",
            "telephone_number": "817-818-8433",
            "fax_number": "817-423-7473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENNUPATI",
        "first_name": "ANUPAMA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-03",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "TX",
            "license": "P5523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.