Premswarup Joel Immaraj, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

L4655 Issued in TX

Practice address

110 Memorial Hospital Dr
Huntsville, TX 77340-4940

Phone

(936) 291-3411

NPI assigned

Jun 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Immaraju Joel Premswarup Former name

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

Specialty

Emergency MedicineAlso: Internal Medicine

Education

Other, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Concord Medical Group of Texas PLLCGroup PAC ID 7810117223, 319 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• El Campo Memorial Hospital Hospital, El Campo, TX, CCN 450694

Merit-based Incentive Payment System (MIPS)

Final score

78.92 of 100Reported as group

Quality

71.67

Improvement activities

40

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 and National Provider Directory roles.

• Concord Medical Group of Texas PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1750790762
  Medicare reassignment Care Compare group NPD
• Acs Primary Care Physicians Southwest, PA

  • Emergency Medicine Physician
  • Gainesville, TX
  • NPI 1538101019
  Medicare reassignment NPD
• Jasper Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Jasper, TX
  • NPI 1922781970
  Medicare reassignment NPD
• Sound Physicians Emergency Medicine of Texas PLLC

  • Emergency Medicine Physician
  • Killeen, TX
  • NPI 1518475557
  Medicare reassignment NPD
• Ess Region II LLC

  • Hospitalist Physician
  • Glen Rose, TX
  • NPI 1720262389
  NPD (past)
• Wharton Emergency Medicine Associates PA

  • Emergency Medicine Physician
  • Wharton, TX
  • NPI 1114026770
  NPD (past)
• Hospital Service District No. 2

  • Critical Access Hospital
  • Breaux Bridge, LA
  • NPI 1548263262
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• El Campo Memorial Hospital

  • General Acute Care Hospital
  • El Campo, TX
  • NPI 1003192311
  Care Compare affiliation

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582848000000",
    "number": "1356377915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5447 EMBERWOOD WAY",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774794273",
            "telephone_number": "832-264-4028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 MEMORIAL HOSPITAL DR",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773404940",
            "telephone_number": "936-291-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMMARAJ",
        "first_name": "PREMSWARUP",
        "middle_name": "JOEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "L4655",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L4655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168572909",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168572904",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168572903",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IMMARAJU",
            "last_name": "PREMSWARUP",
            "middle_name": "JOEL",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Huntsville Womens Center, LP
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• HV Wound Care Center
• Katherine Prichard Hyde, O.D.
• Infinite Vision, PLLC
• Interdiscipliinary Pain Management
• Internal Medicine Associates of Huntsville, PLLC
• Ja Robles & Associates Inc
• Dhanya Mary Jacob, DO

• Internal Medicine Physician in Huntsville, TX
• Providers in Huntsville, 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 Feb 28, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.