Individual provider Active NPI

Prasanthi Jasty, M.D

  • Infectious Disease Physician
  • Desoto, TX
National Provider Identifier
1295993434
Registry record updated Jun 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
Q3023 Issued in TX
Practice address
2727 Bolton Boone Dr Ste 109
Desoto, TX 75115-2019
Phone
(972) 283-2370
Fax
(972) 296-0311
NPI assigned
May 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2015

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 P-20357 MD
Infectious Disease Physician 207RI0200X Q3023 TX Primary

Addresses

Primary practice location

2727 Bolton Boone Dr Ste 109
Desoto, TX 75115-2019

Mailing address

2727 Bolton Boone Dr Ste 109
Desoto, TX 75115-2019
Phone (972) 283-2370

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
I20150401001098 TX Practitioner - Infectious DiseasePractitioner - Internal Medicine 9638230188 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 2001
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Mahesh Kottapalli MD PAGroup PAC ID 7214097989, 3 clinicians

Practice addresses (Care Compare)

2727 Bolton Boone Dr
Suite 109
Desoto, TX 75115-2019
Phone (972) 283-2370

Hospital & facility affiliations

  • Methodist Charlton Medical Center Hospital, Dallas, TX, CCN 450723
  • Baylor Scott & White Medical Center- Waxahachie Hospital, Waxahachie, TX, CCN 450372

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P-20357MDMDInternal Medicine Physician
Q3023TXMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mahesh Kottapalli, M.D., P.a. Internal Medicine CurrentSince Mar 1, 2015 Accepting new patients
Mahesh Kottapalli, M.D., P.a. Internal Medicine CurrentSince Mar 1, 2015 Accepting new patients
Medstar Harbor Hospital Physicians LLC Past Accepting new patients

Locations

2727 Bolton Boone Dr
Ste 109
Desoto, TX 75115
Phone (855) 955-2256

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 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": "1211500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433894400000",
    "number": "1295993434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 BOLTON BOONE DR STE 109",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152019",
            "telephone_number": "972-283-2370",
            "fax_number": "972-296-0311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 BOLTON BOONE DR STE 109",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152019",
            "telephone_number": "972-283-2370",
            "fax_number": "972-296-0311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JASTY",
        "first_name": "PRASANTHI",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-23",
        "last_updated": "2015-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "P-20357",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "TX",
            "license": "Q3023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Desoto, TX

Sources for this page

Verify at the official NPI Registry.