Organization Active NPI

Jiya Medical Group PLLC

  • Infectious Disease Physician
  • Dallas, TX
National Provider Identifier
1154895563
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
JIYA MEDICAL GROUP PLLC
Practice address
7 Medical Pkwy
Dallas, TX 75234-7829
Phone
(469) 453-8118
NPI assigned
Jan 18, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Authorized official

Name
Dr. Suresh KachhdiyaNPI 1629365671
Title
President
Phone
(469) 453-8118

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Infectious Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0200X Primary

Addresses

Primary practice location

7 Medical Pkwy
Dallas, TX 75234-7829

Mailing address

PO Box 251104
Plano, TX 75025-1104
Phone (214) 836-6676

Other identifiers 1

IdentifierTypeStateIssuer
763564OtherTXMEDICARE TX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190213001419 TX Part B Supplier - Clinic/Group Practice 4587902747 Receives reassigned benefits from 4 practitioners
Practice locations: Dallas, TX

National Provider Directory

National Provider Directory

Locations

2761 E Trinity Mills Rd
Ste 100
Carrollton, TX 75006
Phone (972) 478-7300

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1547769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723420800000",
    "number": "1154895563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 251104",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750251104",
            "telephone_number": "214-836-6676",
            "fax_number": "678-270-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 MEDICAL PKWY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752347829",
            "telephone_number": "469-453-8118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIYA MEDICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-18",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A",
        "authorized_official_last_name": "KACHHDIYA",
        "authorized_official_first_name": "SURESH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "469-453-8118",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE TX",
            "identifier": "763564",
            "state": "TX"
        }
    ],
    "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 Aug 12, 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.