NPIMap

Individual provider Active NPI

Madhavi Mallareddy, MD

  • Nephrology Physician
  • Mesquite, TX
National Provider Identifier
1215134630
Registry record updated Mar 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
N3859 Issued in TX
Practice address
2698 N Galloway Ave
Suite 104
Mesquite, TX 75150-6383
Phone
(972) 681-4444
Fax
(214) 635-3868
NPI assigned
Jun 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X N3859 TX Primary

Addresses

Primary practice location

2698 N Galloway Ave
Suite 104
Mesquite, TX 75150-6383

Mailing address

2811 Duke of Gloucester St
Suite 103
Desoto, TX 75115-2017
Phone (972) 274-5555

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111202000505 TX Practitioner - Nephrology 8527101880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dallas Renal Group, P.a.Group PAC ID 0244277283, 52 clinicians

Practice addresses (Care Compare)

1222 N Bishop Ave
Suite 500
Dallas, TX 75208-1478
Phone (972) 274-5555

7999 W Virginia Dr
Suite a
Dallas, TX 75237-3845
Phone (888) 616-6322

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Renal Group PA Nephrology CurrentSince Oct 6, 2011 Accepting new patients
WMDC Partners, LLC PastSince Jan 1, 2016 Accepting new patients
Transtreme, LLC Past Accepting new patients
Pacific Nephrology Associates, P.S. Nephrology Past Accepting new patients

Locations

3571 W Wheatland Rd
#101
Dallas, TX 75237
Phone (972) 274-5555

1222 N Bishop Ave
Ste 500
Dallas, TX 75208
Phone (972) 274-5555

2811 Duke of Gloucester St
Ste 103
Desoto, TX 75115
Phone (972) 274-5555

2698 N Galloway Ave
Ste 104
Mesquite, TX 75150
Phone (972) 681-4444

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HEHCAD
  • Direct secure messaging: madhavi.mallareddy@drg.eclinicaldirectplus.com

Organizations & group practices 4

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331769600000",
    "number": "1215134630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 DUKE OF GLOUCESTER ST",
            "address_2": "SUITE 103",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152017",
            "telephone_number": "972-274-5555",
            "fax_number": "972-274-5663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2698 N GALLOWAY AVE",
            "address_2": "SUITE 104",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751506383",
            "telephone_number": "972-681-4444",
            "fax_number": "214-635-3868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLAREDDY",
        "first_name": "MADHAVI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-29",
        "last_updated": "2012-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "N3859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

Verify at the official NPI Registry.