Srikanth Thyagaraj Jyothinagaram, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

Q2456 Issued in TX

Practice address

1650 W College St
Suite 150
Grapevine, TX 76051-3565

Phone

(817) 388-3440

Fax

(817) 388-3441

NPI assigned

May 25, 2007

Last updated

Aug 27, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 4

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Star MD of Arlington PLLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Dallas, TX
  • NPI 1124894308

  Internal Medicine

  Medicare reassignment NPD Authorized official
• Healthtexas Provider Network

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1760488936

  Internal Medicine

  Medicare reassignment NPD
• Lonestar Hospital Medicine Associates, PA

  • Hospitalist Physician
  • Mansfield, TX
  • NPI 1518237429

  Internal Medicine

  Medicare reassignment NPD
• Star Ed PLLC

  • Emergency Medicine Physician
  • Flower Mound, TX
  • NPI 1669097382
  NPD Authorized official
• Healthtexas Provider Network

  dba Symmetry Anesthesia

  • Anesthesiology Physician
  • Lakeway, TX
  • NPI 1104714583
  NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Colleyville, TX
  • NPI 1235135906

  Internal Medicine

  NPD

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440633600000",
    "number": "1306057856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 W COLLEGE ST",
            "address_2": "SUITE 150",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513565",
            "telephone_number": "817-388-3440",
            "fax_number": "817-388-3441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 W COLLEGE ST",
            "address_2": "SUITE 150",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513565",
            "telephone_number": "817-388-3440",
            "fax_number": "817-388-3441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JYOTHINAGARAM",
        "first_name": "SRIKANTH",
        "middle_name": "THYAGARAJ",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2015-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301089867",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "Q2456",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MI",
            "license": "4301089867",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306057856",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM GROUP NUMBER",
            "identifier": "700E012740",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5186424",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN LICENSE",
            "identifier": "SJ089867",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victoria Juarez
• Patricia L Juline, NP
• Nazish Juma, FNP-C
• Jun Zhao
• JW Eye Associates, PLLC (Key Whitman Eye Center)
• K&M Healthcare Services PLLC
• Ashley Tyshann Kadlubar, MS, RD, LD
• Peter A. Kahle, PSYCHOLOGIST
• Kimberly Loraine Kammerer, FNP-C
• Judith Perlstein Kane, M.D.

• Internal Medicine Physician in Grapevine, TX
• Providers in Grapevine, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.