Individual provider Active NPI

Leena Pathikonda, D.O.

  • Internal Medicine Physician
  • Dallas, TX
National Provider Identifier
1306293089
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
BP10056893 Issued in TX
Practice address
3417 Gaston Ave Ste 1000
Dallas, TX 75246
Phone
(469) 800-9000
NPI assigned
May 23, 2016
Last updated
Nov 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X BP10056893 TX Primary

Addresses

Primary practice location

3417 Gaston Ave Ste 1000
Dallas, TX 75246

Mailing address

3417 Gaston Ave Ste 1000
Dallas, TX 75246-2037
Phone (469) 800-9000

Other practice location 1

441 N. Beckley Avenue
Dallas, TX 75203
Phone (214) 947-8999

Other practice location 2

441 N. Beckley Avenue
Dallas, TX 75203
Phone (214) 947-8999

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lpathikonda556764@direct.sw.org

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
I20191024000160 TX Practitioner - Internal Medicine 6002102480 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10056893TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Oct 14, 2019 Accepting new patients
Healthtexas Provider Network Internal Medicine CurrentSince Oct 14, 2019 Accepting new patients
Arze Medical PLLC CurrentSince Dec 1, 2023 Accepting new patients

Locations

3417 Gaston Ave
Ste 1000
Dallas, TX 75246
Phone (469) 800-9000

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

4835 Lyndon B Johnson Fwy
Ste 900
Dallas, TX 75244
Phone (469) 340-1366

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (469) 800-8648

8130 Meadow Rd
Dallas, TX 75231
Phone (214) 765-3300

4201 Stonegate Blvd
Ft Worth, TX 76109
Phone (817) 924-5440

5242 Medical Dr
Rockwall, TX 75032
Phone (469) 248-5853

250 W British Flying School Blvd
Terrell, TX 75160
Phone (469) 434-1145

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1463961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1306293089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3417 GASTON AVE STE 1000",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462037",
            "telephone_number": "469-800-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3417 GASTON AVE STE 1000",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75246",
            "telephone_number": "469-800-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "441 N. Beckley Avenue",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "75203",
            "country_code": "US",
            "telephone_number": "214-947-8999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "441 N. Beckley Avenue",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "75203",
            "country_code": "US",
            "telephone_number": "214-947-8999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATHIKONDA",
        "first_name": "LEENA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-23",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "BP10056893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lpathikonda556764@direct.sw.org",
            "affiliation": "N",
            "address_1": "3417 Gaston Ave Ste 1000",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "75246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.