Individual provider Active NPI

Ruth Nisha Krishnan, M.D.

  • Internal Medicine Physician
  • Dallas, TX
National Provider Identifier
1265480685
Registry record updated Feb 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
N6438 Issued in TX
Practice address
4001 Worth St
Dallas, TX 75246-1608
Phone
(214) 828-1745
Fax
(214) 828-1734
NPI assigned
May 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD0000039396 TN
Internal Medicine Physician 207R00000X N6438 TX Primary

Addresses

Primary practice location

4001 Worth St
Dallas, TX 75246-1608

Mailing address

4001 Worth St
Dallas, TX 75246-1608
Phone (214) 828-1745

Other identifiers 2

IdentifierTypeStateIssuer
216944301MedicaidTX
8CL572OtherTXBCBSTX

Other names 1

  • Ruth Nisha Sundara Former name

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
I20101122000364 TX Practitioner - Internal Medicine 3476582990 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD0000039396TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Jul 28, 2010 Accepting new patients
Healthtexas Provider Network Internal Medicine CurrentSince Jul 28, 2010 Accepting new patients

Locations

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

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.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298505600000",
    "number": "1265480685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 WORTH ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461608",
            "telephone_number": "214-828-1745",
            "fax_number": "214-828-1734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 WORTH ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461608",
            "telephone_number": "214-828-1745",
            "fax_number": "214-828-1734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISHNAN",
        "first_name": "RUTH",
        "middle_name": "NISHA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2011-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD0000039396",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N6438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "216944301",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "8CL572",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RUTH",
            "last_name": "SUNDARA",
            "middle_name": "NISHA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.