Venkata Amarendra Mangalagiri, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R6043 Issued in TX

Practice address

901 Walnut Hill Dr
Longview, TX 75605-5054

Phone

(903) 759-7200

NPI assigned

Jul 8, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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

Specialty

Family Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Accentcare Home Health of Texas Home health agency, Longview, TX, CCN 679090
• Christus Good Shepherd Home health agency, Longview, TX, CCN 457691
• Christus Good Shepherd Medical Center Hospital, Longview, TX, CCN 450032

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vmangalagiri346507@christushealth.direct-ci.net

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.

• Christus Trinity Clinic Texas

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1285684225
  Medicare reassignment Care Compare group NPD
• Christus Trinity Clinic Texas

  • Rural Health Clinic/Center
  • Winnsboro, TX
  • NPI 1801673165
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Christus Good Shepherd Medical Center

  • General Acute Care Hospital
  • Longview, TX
  • NPI 1124092036
  Care Compare affiliation
• GSHS Home Health, LLC

  • Home Health Agency
  • Longview, TX
  • NPI 1023128220
  Care Compare affiliation
• Texas Home Health Skilled Services,LP

  • Home Health Agency
  • Longview, TX
  • NPI 1669695722
  Care Compare affiliation

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

{
    "created_epoch": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1154618239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 NORTH MAIN",
            "city": "LOVINGTON",
            "state": "NM",
            "postal_code": "882602830",
            "telephone_number": "575-396-6611",
            "fax_number": "575-396-1454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 WALNUT HILL DR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055054",
            "telephone_number": "903-759-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "705 E Marshall Ave Ste 1002",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756015660",
            "country_code": "US",
            "telephone_number": "903-759-7200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 Broadway Ave",
            "address_purpose": "LOCATION",
            "city": "Gladewater",
            "state": "TX",
            "postal_code": "756475040",
            "country_code": "US",
            "telephone_number": "903-315-5630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANGALAGIRI",
        "first_name": "VENKATA",
        "middle_name": "AMARENDRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-08",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD2014-0037",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R6043",
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "98570504",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diana Malone, MD
• David W Maly, CRNA
• Soumya Mamidi
• Edgar Ryan Mancilla
• Geeta Gyaneshwari Mandavilli
• Audrey N Mangwiro, M.D.
• Suganya Manivannan, MD
• Jodie Manley, M.S., CCC-SLP
• Darvy Lee Mann, MD
• True Sandlin Mann, PH.D

• Family Medicine Physician in Longview, TX
• Providers in Longview, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.