NPIMap

Individual provider Active NPI

Kavita S Vyas, M.D.

  • Internal Medicine Physician
  • Nacogdoches, TX
National Provider Identifier
1346246964
Registry record updated Apr 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
K9697 Issued in TX
Practice address
607 Russell Blvd
A
Nacogdoches, TX 75965-1247
Phone
(936) 560-2920
Fax
(866) 861-6312
NPI assigned
Jun 28, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2017

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 K9697 TX Primary
Adult Medicine Physician 207QA0505X K9697 TX

Addresses

Primary practice location

607 Russell Blvd
A
Nacogdoches, TX 75965-1247

Mailing address

607 Russell Blvd
A
Nacogdoches, TX 75965-1247
Phone (936) 560-2920

Other identifiers 1

IdentifierTypeStateIssuer
043017501MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060619000281 TX Practitioner - Internal MedicinePractitioner - Family Practice 4284646027 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Family Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Catalyst Physician Group - Etx PLLCGroup PAC ID 5991235848, 5 clinicians

Practice addresses (Care Compare)

607 Russell Blvd
Suite a
Nacogdoches, TX 75965-1247
Phone (936) 560-2920

607 Russell Blvd a
Nacogdoches, TX 75965-1247
Phone (936) 560-2920

Hospital & facility affiliations

  • Advantage Plus Homecare Home health agency, Nacogdoches, TX, CCN 747683
  • Accentcare Home Health of Texas Home health agency, Nacogdoches, TX, CCN 679108
  • Happy at Home Healthcare Home health agency, Henderson, TX, CCN 677275
  • A Pineywoods Home Health Care Inc Home health agency, Lufkin, TX, CCN 677545
  • Reliant at Home Home health agency, Lufkin, TX, CCN 747328
  • Nacogdoches Medical Center Hospital, Nacogdoches, TX, CCN 450656
  • Nacogdoches Memorial Hospital Hospital, Nacogdoches, TX, CCN 450508
  • Stallings Court Nursing and Rehabilitation Nursing home, Nacogdoches, TX, CCN 676147
  • Willowbrook Nursing Center Nursing home, Nacogdoches, TX, CCN 455700
  • Westward Trails Nursing and Rehabilitation Nursing home, Nacogdoches, TX, CCN 455959

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K9697TXMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nacogdoches Medical Clinic PLLC Adult Medicine CurrentSince Oct 15, 2000 Accepting new patients
Catalyst Physician Group - Etx PLLC Internal Medicine CurrentSince Feb 3, 2025 Accepting new patients
Westward I Enterprises, LLC Past Accepting new patients
Winnie-Stowell Hospital District Past Accepting new patients

Locations

1743 Southview Cir
Center, TX 75935
Phone (903) 692-3219

206 Gene Samford Dr
Ste B
Lufkin, TX 75904
Phone (936) 634-3396

607 Russell Blvd
Nacogdoches, TX 75965
Phone (936) 560-2920

607 Russell Blvd
#A
Nacogdoches, TX 75965
Phone (936) 560-2920

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/30724/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kavita.vyas.1@30724.direct.athenahealth.com

Organizations & group practices 4

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 11

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": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492560000000",
    "number": "1346246964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 RUSSELL BLVD",
            "address_2": "A",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759651247",
            "telephone_number": "936-560-2920",
            "fax_number": "866-861-6312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 RUSSELL BLVD",
            "address_2": "A",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759651247",
            "telephone_number": "936-560-2920",
            "fax_number": "866-861-6312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VYAS",
        "first_name": "KAVITA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-28",
        "last_updated": "2017-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K9697",
            "primary": true
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "TX",
            "license": "K9697",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043017501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nacogdoches, TX

Sources for this page

Verify at the official NPI Registry.