Individual provider Active NPI

Srilatha Kothandaraman, M.D.

  • Rheumatology Physician
  • Dallas, TX
National Provider Identifier
1225340417
Registry record updated Jul 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
Q4792 Issued in TX
Practice address
712 N Washington Ave
Suite 300
Dallas, TX 75246-1619
Phone
(214) 823-6503
Fax
(214) 826-0605
NPI assigned
Jul 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X Q4792 TX Primary

Addresses

Primary practice location

712 N Washington Ave
Suite 300
Dallas, TX 75246-1619

Mailing address

712 N Washington Ave
Suite 300
Dallas, TX 75246-1619
Phone (214) 823-6503

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150804005576 TX Practitioner - Rheumatology 9830403815 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Temple University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arthritis Centers of Texas, P.a.Group PAC ID 3476548256, 4 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

3600 Gaston Ave
Suite 100
Dallas, TX 75246-1801
Phone (214) 823-6503

800 College Pkwy
Lewisville, TX 75077-3503
Phone (972) 420-8543

Hospital & facility affiliations

  • Medical City Plano Hospital, Plano, TX, CCN 450651
  • Baylor Scott & White Institute for Rehabilitation Inpatient rehabilitation facility, Dallas, TX, CCN 453036

Merit-based Incentive Payment System (MIPS)

Final score
93.15 of 100Reported as individual
Quality
86.3
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q4792TXMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arthritis Centers of Texas PA Rheumatology CurrentSince Jul 8, 2015 Accepting new patients

Locations

712 N Washington Ave
Ste 300
Dallas, TX 75246
Phone (214) 365-5050

3600 Gaston Ave
Ste 100
Dallas, TX 75246
Phone (214) 823-6503

2929 N Central Expy
Ste 225
Richardson, TX 75080
Phone (214) 823-6503

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GGAJAA

Organizations & group practices 2

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 2

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": "1278288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436227200000",
    "number": "1225340417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 N WASHINGTON AVE",
            "address_2": "SUITE 300",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461619",
            "telephone_number": "214-823-6503",
            "fax_number": "214-826-0605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 N WASHINGTON AVE",
            "address_2": "SUITE 300",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461619",
            "telephone_number": "214-823-6503",
            "fax_number": "214-826-0605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTHANDARAMAN",
        "first_name": "SRILATHA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-05",
        "last_updated": "2015-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "TX",
            "license": "Q4792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.