NPIMap

Organization Active NPI

Star MD of Arlington PLLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Dallas, TX
National Provider Identifier
1124894308
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
Legal business name
STAR MD OF ARLINGTON PLLC
Practice address
9440 Poppy Dr
Dallas, TX 75218-3652
Phone
(214) 324-6100
NPI assigned
Nov 29, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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

Authorized official

Name
Srikanth Jyothinagaram, MDNPI 1306057856
Title
President
Phone
(248) 376-9822

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207PE0004X Primary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X

Addresses

Primary practice location

9440 Poppy Dr
Dallas, TX 75218-3652

Mailing address

2201 Long Prairie Rd Ste 107
Flower Mound, TX 75022-4964
Phone (248) 376-9822

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231222002125 TX Part B Supplier - Clinic/Group Practice 8628428265 Receives reassigned benefits from 21 practitioners
Practice locations: Dallas, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 21

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1701216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705622400000",
    "number": "1124894308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 LONG PRAIRIE RD STE 107",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750224964",
            "telephone_number": "248-376-9822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9440 POPPY DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752183652",
            "telephone_number": "214-324-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAR MD OF ARLINGTON PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-29",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A",
        "authorized_official_last_name": "JYOTHINAGARAM",
        "authorized_official_first_name": "SRIKANTH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-376-9822",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.