Active NPI
Srinivas Kodali, M.D
- Hematology & Oncology Physician
- Beaumont, TX
National Provider Identifier
1295979813
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- N1713
- Practice address
- 3070 College St Ste 301
Beaumont, TX 77701-4688 - Phone
- (409) 813-1686
- Fax
- (409) 813-3052
- NPI assigned
- Apr 27, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | N1713 | TX | Primary |
Addresses
Primary practice location
3070 College St Ste 301
Beaumont, TX 77701-4688
Mailing address
PO Box 911230
Dallas, TX 75391-1230
Phone (972) 997-8000
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8BZ885 | Other | TX | BCBS |
| 202324401 | Medicaid | TX | |
| P00725231 | Other | TX | RAILROAD MEDICARE |
| 202324402 | Medicaid | TX |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090612000063 | TX | Practitioner - Hematology/Oncology | 0547310591 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Hematology/Oncology
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Texas Oncology PA
Practice addresses (Care Compare)
3010 Harrison St
Beaumont, TX 77702-1041
Phone (409) 899-7180
Hospital & facility affiliations
- Christus Southeast Texas- St Elizabeth
- The Medical Center of Southeast Texas
- Baptist Beaumont Hospital
- Christus Jasper Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.12 of 100
- Quality
- 67.48
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Texas Oncology PA | Hematology & Oncology | Current | Accepting new patients |
| Texas Oncology PA | Hematology & Oncology | Current | Accepting new patients |
| Texas Oncology PA | Hematology & Oncology | Current | Accepting new patients |
Locations
690 N 14th St
Beaumont, TX 77702
Phone (409) 899-7047
3010 Harrison Ave
Beaumont, TX 77702
Phone (409) 899-7047
3070 College St
Ste 301
Beaumont, TX 77701
Phone (409) 813-1686
7848 Gateway Blvd E
El Paso, TX 79915
Phone (915) 599-1313
925 Gessner Rd
Ste 310
Houston, TX 77024
Phone (713) 467-1630
2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500
2501 Jimmy Johnson Blvd
Ste 205
Port Arthur, TX 77640
Phone (409) 724-2002
Interoperability endpoints
- srinivas.kodali@txo.ikm.direct-ci.com
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 and National Provider Directory roles.
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Beaumont, TX
- NPI 1093744187
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1240790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466985600000",
"number": "1295979813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 911230",
"city": "DALLAS",
"state": "TX",
"postal_code": "753911230",
"telephone_number": "972-997-8000",
"fax_number": "972-234-0813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3070 COLLEGE ST STE 301",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "777014688",
"telephone_number": "409-813-1686",
"fax_number": "409-813-3052"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KODALI",
"first_name": "SRINIVAS",
"name_prefix": "Dr.",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-04-27",
"last_updated": "2016-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "TX",
"license": "N1713",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8BZ885",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "202324401",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00725231",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "202324402",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beaumont, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.