Individual provider Active NPI

Vamseen Jetti, M.D.

  • Anesthesiology Physician
  • McKinney, TX
National Provider Identifier
1275713059
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD432966 Issued in PA
Practice address
4510 Medical Center Dr Ste 211
McKinney, TX 75069-1602
Phone
(469) 541-1600
Fax
(469) 541-1612
NPI assigned
Nov 8, 2007
Last updated
Sep 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD432966 PA Primary

Addresses

Primary practice location

4510 Medical Center Dr Ste 211
McKinney, TX 75069-1602

Mailing address

906 W McDermott Dr # 116-371
Allen, TX 75013-6510

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
I20140107001016 TX Practitioner - Anesthesiology 4981763976 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Jefferson Medical College of Thomas Jefferson University, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allen Anesthesia AssociatesGroup PAC ID 2264477140, 94 clinicians

Practice addresses (Care Compare)

1105 Central Expy N
Suite 210
Allen, TX 75013-6102
Phone (972) 747-5840

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD432966PAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allen Anesthesia Associates CurrentSince Jul 1, 2015 Accepting new patients
Premier Anesthesia of Fairmont, WV, a Division of Premier Anesthesia Anesthesiology Past Accepting new patients
Anesthesia Associates of Easton, P C Past Accepting new patients

Locations

1105 Central Expy N
Ste 210
Allen, TX 75013
Phone (972) 747-4646

906 W McDermott Dr
Allen, TX 75013
Phone (918) 812-4755

4401 Coit Rd
Ste 100
Frisco, TX 75035
Phone (214) 619-0120

4510 Medical Center Dr
Ste 211
McKinney, TX 75069
Phone (469) 541-1600

Organizations & group practices 3

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 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": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1275713059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 W MCDERMOTT DR # 116-371",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750136510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 MEDICAL CENTER DR STE 211",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750691602",
            "telephone_number": "469-541-1600",
            "fax_number": "469-541-1612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETTI",
        "first_name": "VAMSEEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-08",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD432966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKinney, TX

Sources for this page

Verify at the official NPI Registry.