Individual provider Active NPI

Srinivas P Kadiyala, MD

  • Pulmonary Disease Physician
  • Lubbock, TX
National Provider Identifier
1275535635
Registry record updated Oct 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
K8772 Issued in TX
Practice address
3621 22ND St
Ste 400
Lubbock, TX 79410-1301
Phone
(806) 791-8484
Fax
(806) 791-8498
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X K8772 TX Primary

Addresses

Primary practice location

3621 22ND St
Ste 400
Lubbock, TX 79410-1301

Mailing address

3621 22ND St
Suite 400
Lubbock, TX 79410-1301
Phone (806) 791-8484

Other identifiers 1

IdentifierTypeStateIssuer
105099901MedicaidTX

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
I20091112000463 TX Practitioner - Pulmonary Disease 2062419500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical GroupGroup PAC ID 6901889393, 228 clinicians

Practice addresses (Care Compare)

2215 Nashville Ave
Lubbock, TX 79410-1105
Phone (806) 725-5844

3815 20TH St
Lubbock, TX 79410-1235
Phone (806) 725-9200

7601 Quaker Ave
Lubbock, TX 79424-3360
Phone (806) 725-9444

9812 Slide Rd
Lubbock, TX 79424-5781
Phone (806) 725-8400

Hospital & facility affiliations

  • Covenant Medical Center Hospital, Lubbock, TX, CCN 450040
  • Grace Surgical Hospital Hospital, Lubbock, TX, CCN 450162
  • Nor-Lea Hospital District Hospital, Lovington, NM, CCN 321305
  • Covenant Childrens Hospital Hospital, Lubbock, TX, CCN 453306
  • Covenant Hospital Plainview Hospital, Plainview, TX, CCN 450539

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K8772TXMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group CurrentSince Nov 1, 2013 Accepting new patients
Covenant Medical Group CurrentSince Nov 1, 2013 Accepting new patients

Locations

3621 22nd St
Ste 400
Lubbock, TX 79410
Phone (806) 791-8484

2215 Nashville Ave
Lubbock, TX 79410
Phone (806) 725-5228

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 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": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318377600000",
    "number": "1275535635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 22ND ST",
            "address_2": "SUITE 400",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101301",
            "telephone_number": "806-791-8484",
            "fax_number": "806-791-8498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3621 22ND ST",
            "address_2": "STE 400",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101301",
            "telephone_number": "806-791-8484",
            "fax_number": "806-791-8498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KADIYALA",
        "first_name": "SRINIVAS",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2011-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TX",
            "license": "K8772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105099901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.