Ilanko Upendran, MD
Individual provider Active NPI Internal Medicine Physician · Tyler, TX
NPI 1124051073 · NPPES record last updated Jun 16, 2020
Key facts
- NPI
- 1124051073
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- L8543 (TX)
- Practice address
- 1000 S Beckham Ave
Tyler, TX 75701-1908 - Phone
- (903) 597-0351
- Fax
- (903) 535-6884
- NPI assigned
- Jul 7, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Etmc Physician Group, Inc.
Practice addresses (Care Compare)
1000 S Beckham Ave
Tyler, TX 75701-1908
Phone (903) 590-5611
18118 FM 344
Flint, TX 75762-6010
Phone (903) 825-3292
2000 S Palestine St
Athens, TX 75751-5610
Phone (903) 676-1000
300 Wilson St
Henderson, TX 75652-5956
Phone (903) 655-6536
409 Cottage Rd
Carthage, TX 75633-1466
Phone (903) 694-4790
Hospital & facility affiliations
- Heart to Heart Hospice of Tyler LTD
- Ut Health East Texas Tyler Regional Hospital
- Ut Health East Texas Carthage Hospital
- Ut Health East Texas Henderson Hospital
- Ut Health East Texas Athens Hospital
- University of Texas Health Science Center at Tyler
- Ut Health East Texas Rehabilitation Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040607001249 | TX | Practitioner - Internal Medicine | 1456333921 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Etmc Physician Group Inc. | Current |
Accepting new patients | |
| Pittsburg Hospital LLC | Internal Medicine | Current |
Accepting new patients |
| Quitman Hospital LLC | Current |
Accepting new patients | |
| Quitman Hospital LLC | Internal Medicine | Current |
Accepting new patients |
| Etmc Physician Group Inc. | Current |
Accepting new patients | |
| Quitman Hospital LLC | Current | Accepting new patients | |
| Pittsburg Hospital, LLC | Current |
Accepting new patients | |
| Tyler Regional Hospital LLC | Past | Accepting new patients | |
| East Texas Medical Center Gilmer | Past | Accepting new patients | |
| Upshur Emergency Medicine Associates PA | Past | Accepting new patients | |
| Starks Medical | Past | Accepting new patients |
Locations
18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292
300 Wilson St
Henderson, TX 75652
Phone (903) 655-6536
2701 US Highway 271 N
Pittsburg, TX 75686
Phone (903) 946-5000
117 N Winnsboro St
Quitman, TX 75783
Phone (903) 763-4505
11937 US Highway 271
Tyler, TX 75708
Phone (903) 877-3451
1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068
912 S Fleishel Ave
Tyler, TX 75701
Phone 90359269011811
Interoperability endpoints
- iupendran355080@ahs.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | L8543 | TX | Yes |
Addresses
Primary practice location
1000 S Beckham Ave
Tyler, TX 75701-1908
Mailing address
PO Box 9477
Tyler, TX 75711-9477
Phone (903) 594-2450
Other providers in Tyler, TX
- University of Texas Health Science Center at Tyler
- University of Texas Health Science Center at Tyler
- University of Texas Health Science Center at Tyler
- University of Texas Health Science Center at Tyler
- University of Texas Health Science Center at Tyler-Facility-Physician
- Sara Upson
- Urology Tyler, PA
- Olivia Urwiller
- Marc Edward Usrey
- Usv Optical Inc.
All providers in Tyler, TX · Internal Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.