Ajay Shubhadeep Kallam, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

Q6432 Issued in TX

Practice address

3571 W Wheatland Rd Ste 101
Dallas, TX 75237-3461

Phone

(972) 274-5555

Fax

(972) 274-5663

NPI assigned

May 20, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

NephrologyAlso: Internal Medicine

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dallas Renal Group, P.a.Group PAC ID 0244277283, 52 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• USRC Premier Cedar Hill Dialysis facility, Cedar Hill, TX, CCN 742511
• Methodist Charlton Medical Center Hospital, Dallas, TX, CCN 450723
• Methodist Rehabilitation Hospital Inpatient rehabilitation facility, Dallas, TX, CCN 673031

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HEHCAD

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.

• Dallas Renal Group PA

  • Nephrology Physician
  • Dallas, TX
  • NPI 1629186168
  Medicare reassignment Care Compare group NPD
• Hospitalist Medicine Physicians of Texas, PLLC

  • Internal Medicine Physician
  • Humble, TX
  • NPI 1629307095
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Usrc Cedar Hill, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cedar Hill, TX
  • NPI 1043742919

  Dialysis facility

  Care Compare affiliation Name & address match
• Methodist Hospitals of Dallas

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1275592131
  Care Compare affiliation
• MHS-CHC I LP

  • Rehabilitation Hospital
  • Dallas, TX
  • NPI 1487848941

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1306003124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3571 W WHEATLAND RD STE 101",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752373461",
            "telephone_number": "972-274-5555",
            "fax_number": "972-274-5663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3571 W WHEATLAND RD STE 101",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752373461",
            "telephone_number": "972-274-5555",
            "fax_number": "972-274-5663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLAM",
        "first_name": "AJAY",
        "middle_name": "SHUBHADEEP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-20",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "Q6432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05919",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dominique Kalil, MD
• Lyle A Kaliser, M.D.
• Sophia Kalish, COTA
• Gokhan Kalkan, MD
• Nitin Kalla
• Deepti Kallam, MD
• Diya Kallam
• Justine Kallaugher, PHD
• Barbara Lynn Kallenbach-Watson, CNP
• Rohini Kallianpur

• Nephrology Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Nephrology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.

Verify at the official NPI Registry.