NPIMap

Organization Active NPI

Sumana Ketha, MD PA

  • Internal Medicine Physician
  • Irving, TX
National Provider Identifier
1356565865
Registry record updated Nov 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SUMANA KETHA, MD PA
Practice address
2925 Skyway Cir N
Irving, TX 75038-3510
Phone
(972) 929-2270
NPI assigned
Apr 13, 2007
Last updated
Nov 15, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2010

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

Authorized official

Name
Sumana Ketha, M.D.NPI 1962447805
Title
Provider
Phone
(214) 282-4367

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2925 Skyway Cir N
Irving, TX 75038-3510

Mailing address

2925 Skyway Cir N
Irving, TX 75038-3510
Phone (972) 247-3060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050613000503 TX Part B Supplier - Clinic/Group Practice 6103860044 Receives reassigned benefits from 7 practitioners
Practice locations: Dallas, TX; Irving, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289779200000",
    "number": "1356565865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 SKYWAY CIR N",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750383510",
            "telephone_number": "972-247-3060",
            "fax_number": "888-841-3651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 SKYWAY CIR N",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750383510",
            "telephone_number": "972-929-2270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMANA KETHA, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2010-11-15",
        "status": "A",
        "authorized_official_last_name": "KETHA",
        "authorized_official_first_name": "SUMANA",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "214-282-4367",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.