NPIMap

Individual provider Active NPI

Katyayan Dwivedi, MD

  • Internal Medicine Physician
  • Denton, TX
National Provider Identifier
1164804068
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
S5364 Issued in TX
Practice address
2900 N Interstate 35 Ste 118
Denton, TX 76201-5143
Phone
(940) 380-8100
NPI assigned
Jun 26, 2015
Last updated
Sep 14, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125067713 IL
Internal Medicine Physician 207R00000X 01080795A IN
Internal Medicine Physician 207R00000X S5364 TX Primary

Addresses

Primary practice location

2900 N Interstate 35 Ste 118
Denton, TX 76201-5143

Mailing address

2900 N Interstate 35 Ste 118
Denton, TX 76201-5143
Phone (940) 380-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180828004127 IN Practitioner - Internal Medicine 5193039733 Reassigns benefits to 1 organization
I20200925000970 TX Practitioner - Internal Medicine 5193039733 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Indiana University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

2900 N Interstate 35
Suite 118
Denton, TX 76201-5143
Phone (940) 380-8100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125067713ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group Current Accepting new patients
Texas Health Physicians Group Internal Medicine CurrentSince Oct 1, 2020 Accepting new patients
Texas Health Physicians Group CurrentSince Oct 1, 2020 Accepting new patients
Indiana University Health Care Associates, Inc CurrentSince Sep 1, 2018 Accepting new patients
University Medical Diagnostic Associates, Inc. Internal Medicine Past Accepting new patients

Locations

5208 Reliable Pkwy
Chicago, IL 60686

1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000

250 N Shadeland Ave
Ste 200
Indianapolis, IN 46219
Phone (317) 962-4836

9650 E Washington St
Ste 100
Indianapolis, IN 46229
Phone (317) 890-5500

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

4333 N Josey Ln
Ste 104
Carrollton, TX 75010
Phone (972) 394-4500

2900 N Interstate 35
Ste 118
Denton, TX 76201
Phone (940) 380-8100

Interoperability endpoints

  • Direct secure messaging: kdwivedi1659593@direct.texashealth.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1435276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1164804068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 N INTERSTATE 35 STE 118",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762015143",
            "telephone_number": "940-380-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 N INTERSTATE 35 STE 118",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762015143",
            "telephone_number": "940-380-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DWIVEDI",
        "first_name": "KATYAYAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-26",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125067713",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01080795A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "S5364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, TX

Sources for this page

Verify at the official NPI Registry.