Individual provider Active NPI

Marykutty Kuriakose, APN

  • Adult Health Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1346792694
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
MK2016 Issued in TX
Practice address
4009 Worth St
Dallas, TX 75246-1608
Phone
(214) 820-9115
NPI assigned
Nov 2, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X MK2016 TX Primary

Addresses

Primary practice location

4009 Worth St
Dallas, TX 75246-1608

Mailing address

8332 Charleston St
Irving, TX 75063-8000
Phone (214) 714-7156

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mkuriakose544238@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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161222000711 TX Practitioner - Nurse Practitioner 2567743933 Reassigns benefits to 3 organizations
Practice locations: Irving, TX

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
MK2016TXMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Sep 3, 2019 Accepting new patients
Healthtexas Provider Network CurrentSince Sep 3, 2019 Accepting new patients
Home Visiting Doctors Management LLC CurrentSince Oct 19, 2016 Accepting new patients
American Visiting Doctors LLC CurrentSince Oct 19, 2016 Accepting new patients
Transitional and Chronic Care PLLC PastSince Mar 4, 2021 Accepting new patients
Healthtexas Provider Network PastSince May 16, 2021 Accepting new patients
Texas Outpatient Services PA PastSince May 16, 2021 Accepting new patients

Locations

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

5050 Quorum Dr
Ste 700
Dallas, TX 75254
Phone (214) 402-0101

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

Interoperability endpoints

  • Direct secure messaging: mkuriakose544238@direct.sw.org

Organizations & group practices 7

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": "1478044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1346792694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8332 CHARLESTON ST",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750638000",
            "telephone_number": "214-714-7156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4009 WORTH ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461608",
            "telephone_number": "214-820-9115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURIAKOSE",
        "first_name": "MARYKUTTY",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-02",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "MK2016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkuriakose544238@direct.sw.org",
            "affiliation": "N",
            "address_1": "4009 Worth St",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752461608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.