NPIMap

Individual provider Active NPI

Lakshmi Sambathkumar, MD

  • Internal Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1063657740
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
N1122 Issued in TX
Practice address
1025 College Ave
Fort Worth, TX 76104-3013
Phone
(817) 871-9069
NPI assigned
Dec 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X N1122 TX Primary

Addresses

Primary practice location

1025 College Ave
Fort Worth, TX 76104-3013

Mailing address

1300 W Terrell Ave FL 2
Fort Worth, TX 76104-2820
Phone (817) 820-4906

Other practice location 1

1300 W Terrell Ave Fl 2
Fort Worth, TX 76104-2820
Phone (817) 820-4906

Other identifiers 1

IdentifierTypeStateIssuer
203473802MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090504000331 TX Practitioner - Infectious DiseasePractitioner - Internal Medicine 6800944711 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Centers for Infectious Disease Associates PAGroup PAC ID 4880596451, 17 clinicians

Practice addresses (Care Compare)

118 Lynn Ave
Suite 100
Lewisville, TX 75057-3706
Phone (214) 912-2064

3410 Worth St
Suite 790
Dallas, TX 75246-2046
Phone (817) 810-9810

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.77 of 100Reported as group
Quality
92.76
Improvement activities
40
Cost
78.94

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue38
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N1122TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Centers for Infectious Disease Associates PA CurrentSince Jul 1, 2017 Accepting new patients
Tarrant County Infectious Disease Associates PastSince Oct 6, 2019 Accepting new patients

Locations

3410 Worth St
Ste 780
Dallas, TX 75246
Phone (817) 810-9810

3410 Worth St
Ste 790
Dallas, TX 75246
Phone (817) 810-9810

1025 College Ave
Fort Worth, TX 76104
Phone (817) 810-9810

1125 College Ave
Ft Worth, TX 76104
Phone (817) 336-1640

Interoperability endpoints

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

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 8

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": "1228780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1063657740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W TERRELL AVE FL 2",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042820",
            "telephone_number": "817-820-4906",
            "fax_number": "817-820-4815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 COLLEGE AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043013",
            "telephone_number": "817-871-9069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 W Terrell Ave Fl 2",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761042820",
            "country_code": "US",
            "telephone_number": "817-820-4906",
            "fax_number": "817-820-4815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMBATHKUMAR",
        "first_name": "LAKSHMI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-09",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N1122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203473802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.