Individual provider Active NPI

Vani Kotha, M.D

  • Endocrinology, Diabetes & Metabolism Physician
  • Bedford, TX
National Provider Identifier
1124233846
Registry record updated Oct 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
M6242 Issued in TX
Practice address
1615 Hospital Pkwy Ste 202
Bedford, TX 76022-5935
Phone
(817) 786-8686
Fax
(866) 869-0489
NPI assigned
May 14, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X M6242 TX Primary

Addresses

Primary practice location

1615 Hospital Pkwy Ste 202
Bedford, TX 76022-5935

Mailing address

1615 Hospital Pkwy Ste 202
Bedford, TX 76022-5935
Phone (817) 786-8686

Other identifiers 1

IdentifierTypeStateIssuer
186267402MedicaidTX

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
I20070905000379 TX Practitioner - EndocrinologyPractitioner - Internal Medicine 6305939455 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1615 Hospital Pkwy
Suite 202
Bedford, TX 76022-5935
Phone (817) 786-8686

Hospital & facility affiliations

  • Texas Health Harris Methodist Hurst-Euless-Bedford Hospital, Bedford, TX, CCN 450639

Merit-based Incentive Payment System (MIPS)

Final score
85.78 of 100Reported as individual
Quality
83.94
Improvement activities
40
Cost
74.01

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tarrant Endocrine Associates, PLLC Endocrinology, Diabetes & Metabolism CurrentSince Feb 1, 2019 Accepting new patients
Deuteronomy Past Accepting new patients

Locations

1615 Hospital Pkwy
Ste 202
Bedford, TX 76022
Phone (301) 326-8646

Interoperability endpoints

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

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 1

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": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602892800000",
    "number": "1124233846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 HOSPITAL PKWY STE 202",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760225935",
            "telephone_number": "817-786-8686",
            "fax_number": "866-869-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 HOSPITAL PKWY STE 202",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760225935",
            "telephone_number": "817-786-8686",
            "fax_number": "866-869-0489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTHA",
        "first_name": "VANI",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2020-10-17",
        "certification_date": "2020-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "TX",
            "license": "M6242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "186267402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, TX

Sources for this page

Verify at the official NPI Registry.