Individual provider Active NPI

Sharmila Devidoss, M.D.

  • Nephrology Physician
  • Southlake, TX
National Provider Identifier
1124169396
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
P5617 Issued in TX
Practice address
701 Monte Carlo Dr
Southlake, TX 76092-1159
Phone
(817) 733-9367
NPI assigned
Feb 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X P5617 TX Primary
Nephrology Physician 207RN0300X MD.15390R LA

Addresses

Primary practice location

701 Monte Carlo Dr
Southlake, TX 76092-1159

Mailing address

701 Monte Carlo Dr
Southlake, TX 76092-1159
Phone (817) 733-9367

Other names 1

  • Dr. Ninoo Devidoss Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, LA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20141223000871 TX Practitioner - Nephrology 1557684503 Reassigns benefits to 1 organization
I20221102000568 LA Practitioner - Nephrology 1557684503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Louisiana State University School of Medicine in New Orleans, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Texas Kidney Disease AssociatesGroup PAC ID 0941296107, 26 clinicians

Practice addresses (Care Compare)

3315 Colorado Blvd
Suite 102
Denton, TX 76210-6885
Phone (940) 320-1708

Hospital & facility affiliations

  • Medical City Dallas Hospital Hospital, Dallas, TX, CCN 450647

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.15390RLAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Monogram Health Professional Services PC Multi-Specialty CurrentSince Oct 1, 2022 Accepting new patients
North Texas Kidney Disease Associates Multi-Specialty CurrentSince Oct 6, 2025 Accepting new patients
North Texas Kidney Disease Associates Multi-Specialty CurrentSince Oct 6, 2025 Accepting new patients

Locations

2900 Westfork Dr
Ste 401
Baton Rouge, LA 70827
Phone (225) 953-0895

5410 Maryland Way
Ste 400
Brentwood, TN 37027

5410 Maryland Way
Ste 301
Brentwood, TN 37027
Phone (615) 762-3845

3315 Colorado Blvd
Ste 102
Denton, TX 76210
Phone (940) 320-1708

6331 Boulevard 26
Ste 220
North Richland Hills, TX 76180
Phone (817) 628-0284

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 2

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": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1124169396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 MONTE CARLO DR",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760921159",
            "telephone_number": "817-733-9367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 MONTE CARLO DR",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760921159",
            "telephone_number": "817-733-9367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVIDOSS",
        "first_name": "SHARMILA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "P5617",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "LA",
            "license": "MD.15390R",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NINOO",
            "last_name": "DEVIDOSS",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Southlake, TX

Sources for this page

Verify at the official NPI Registry.