Individual provider Active NPI

Prathima Nagireddy, M.D

  • Public Health & General Preventive Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1306133731
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
T4011 Issued in TX
Practice address
400 N Beach St Ste 104
Fort Worth, TX 76111-7070
Phone
(817) 831-1750
NPI assigned
Jul 6, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X 036-148418 IL
Public Health & General Preventive Medicine Physician 2083P0901X 148418 IL
General Practice Physician 208D00000X 75992 GA
Public Health & General Preventive Medicine Physician 2083P0901X T4011 TX Primary

Addresses

Primary practice location

400 N Beach St Ste 104
Fort Worth, TX 76111-7070

Mailing address

6255 W Sunset Blvd FL 21
Los Angeles, CA 90028-7422
Phone (323) 860-5200

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
I20220809003025 TX Practitioner - Preventive Medicine 3173819778 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-148418ILMDPreventive Medicine/Occupational Environmental Medicine Physician
148418ILMDPublic Health & General Preventive Medicine Physician
T4011TXMDPublic Health & General Preventive Medicine Physician
75992GAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care PA CurrentSince Jul 14, 2025 Accepting new patients
American Current Care, P.a. Current Accepting new patients
American Current Care P.a. CurrentSince Jul 14, 2025 Accepting new patients
AIDS Healthcare Foundation Texas Inc CurrentSince Apr 28, 2022 Accepting new patients
AIDS Healthcare Foundation Texas Inc PastSince Apr 10, 2022 Accepting new patients

Locations

6255 W Sunset Blvd
Fl 21
Los Angeles, CA 90028
Phone (323) 860-5200

15810 Midway Rd
Addison, TX 75001
Phone (972) 458-8111

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

3817 Stagg Dr
Beaumont, TX 77701
Phone (409) 813-1920

4025 Spid Dr
Corpus Christi, TX 78411
Phone (361) 852-8255

7777 Forest Ln
Ste B122
Dallas, TX 75230
Phone (972) 383-1060

1002 Abc Ave
Ste 600
Freeport, TX 77541
Phone (979) 233-6571

400 N Beach St
Ste 104
Ft Worth, TX 76111
Phone (817) 831-1750

12345 Katy Fwy
Houston, TX 77079
Phone (281) 679-5600

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1306133731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6255 W SUNSET BLVD FL 21",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900287422",
            "telephone_number": "323-860-5200",
            "fax_number": "323-467-7119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N BEACH ST STE 104",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761117070",
            "telephone_number": "817-831-1750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGIREDDY",
        "first_name": "PRATHIMA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-06",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "IL",
            "license": "036-148418",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "IL",
            "license": "148418",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "75992",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "TX",
            "license": "T4011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.