Active NPI
Vittal Kumar Chundru, M.D.
- Internal Medicine Physician
- Tyler, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- P3304
- Practice address
- 800 E Dawson St
Tyler, TX 75701-2036 - Phone
- (903) 606-4129
- Fax
- (903) 606-1201
- NPI assigned
- Mar 13, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | ME101125 | FL | |
| Hospitalist Physician | 208M00000X | 30627 | OK | |
| Hospitalist Physician | 208M00000X | P3304 | TX | |
| Internal Medicine Physician | 207R00000X | P3304 | TX | Primary |
Addresses
Primary practice location
800 E Dawson St
Tyler, TX 75701-2036
Mailing address
6600 S Yale Ave
Suite 1400
Tulsa, OK 74136-3347
Phone (918) 488-6001
Other practice location 1
6161 S Yale Ave
Tulsa, OK 74136-1902
Phone (918) 502-1900
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 281301700 | Medicaid | FL | |
| 310170108 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P3304 | TX | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iowa Physicians Clinic Medical Foundation | Internal Medicine | Current | Accepting new patients |
| University of Texas Southwestern Medical Center at Dallas | Current | Accepting new patients | |
| St Luke'S Methodist Hospital | Current | Accepting new patients | |
| Sioux City Hospitalist Group, LLC | Hospitalist | Current | Accepting new patients |
| St Francis Medical Center, Inc | Past | Accepting new patients |
Locations
4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950
4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150
1026 A Ave NE
Cedar Rapids, IA 52402
Phone (319) 369-5970
801 5th St
Sioux City, IA 51101
Phone (712) 279-2010
2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563
1801 Inwood Rd
Fl Seventh
Dallas, TX 75235
Interoperability endpoints
- vchundru1024901@direct.unitypoint.org
- https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
Organizations & group practices 5
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.
-
- General Practice Physician
- West Des Moines, IA
- NPI 1366425274
Internal Medicine
-
- Hospitalist Physician
- Sioux City, IA
- NPI 1427789148
-
- Anesthesiology Physician
- Dallas, TX
- NPI 1942270566
-
- General Acute Care Hospital
- Cedar Rapids, IA
- NPI 1083708226
-
- Rehabilitation Hospital Unit
- Monroe, LA
- NPI 1013906239
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610323200000",
"number": "1073784484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6600 S YALE AVE",
"address_2": "SUITE 1400",
"city": "TULSA",
"state": "OK",
"postal_code": "741363347",
"telephone_number": "918-488-6001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 E DAWSON ST",
"city": "TYLER",
"state": "TX",
"postal_code": "757012036",
"telephone_number": "903-606-4129",
"fax_number": "903-606-1201"
}
],
"practiceLocations": [
{
"address_1": "6161 S Yale Ave",
"address_purpose": "LOCATION",
"city": "Tulsa",
"state": "OK",
"postal_code": "741361902",
"country_code": "US",
"telephone_number": "918-502-1900",
"fax_number": "918-494-6303",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHUNDRU",
"first_name": "VITTAL",
"middle_name": "KUMAR",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-13",
"last_updated": "2021-01-11",
"certification_date": "2021-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME101125",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "OK",
"license": "30627",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "TX",
"license": "P3304",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "P3304",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "281301700",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "310170108",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.