Sudhakar Konda, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036-124365 Issued in IL

Practice address

901 Crystal Falls Pkwy Ste 103
Leander, TX 78641-1931

Phone

(512) 259-2198

NPI assigned

Aug 31, 2007

Last updated

Jan 19, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, TX2 enrollments

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 2

Specialty

Family Practice

Education

Other, 2002

Medicare assignment

May accept Medicare assignment

Group practices

Permian Basin Community Centers for Mental Health and Mental RetardatiGroup PAC ID 8426955865, 19 clinicians

Texas Tech University Health Sciences Center OdessaGroup PAC ID 8426044256, 58 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medical Center Hospital Hospital, Odessa, TX, CCN 450132

Procedures performed for Medicare patients

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

• Permian Basin Community Centers for Mental Health & Mental Retardation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Midland, TX
  • NPI 1700976453
  Medicare reassignment Care Compare group NPD
• Texas Tech University Health Sciences Center Odessa

  • Family Medicine Physician
  • Odessa, TX
  • NPI 1407845084
  Medicare reassignment Care Compare group NPD
• Permian Basin Community Centers for Mental Health & Mental Retardation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Alpine, TX
  • NPI 1851464119
  NPD
• Decatur Memorial Hospital

  • General Acute Care Hospital
  • Decatur, IL
  • NPI 1164477725

  Family Medicine

  NPD
• Decatur Memorial Hospital

  dba Professional Fees

  • Multi-Specialty Clinic/Center
  • Decatur, IL
  • NPI 1477276301
  NPD
• Ector County Hospital District

  dba Medical Center Hospital

  • General Acute Care Hospital
  • Odessa, TX
  • NPI 1740273994
  NPD (past)
• Permian Basin Community Centers for Mental Health & Mental Retardation

  • Counselor
  • Midland, TX
  • NPI 1649442310
  NPD (past)
• Nehemiah Tan, MD, S.C.

  • Rheumatology Physician
  • Decatur, IL
  • NPI 1649281270
  NPD (past)

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

• Ector County Hospital District

  dba MCH Family Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Odessa, TX
  • NPI 1578265302

  Hospital

  Care Compare affiliation
• Ector County Hospital District

  dba Medical Center Hospital

  • General Acute Care Hospital
  • Odessa, TX
  • NPI 1740273994
  Care Compare affiliation

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

{
    "created_epoch": "1188518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1376737346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 CRYSTAL FALLS PKWY OFC",
            "city": "LEANDER",
            "state": "TX",
            "postal_code": "786411922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 CRYSTAL FALLS PKWY STE 103",
            "city": "LEANDER",
            "state": "TX",
            "postal_code": "786411931",
            "telephone_number": "512-259-2198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONDA",
        "first_name": "SUDHAKAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-31",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-124365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jin-Yee Kim, MS, CCC-SLP
• Supawan Kincheloe, PMHNP-BC
• Cassidy Kiris, MS, BCBA
• Jarrett Dale Kitchens
• Katelyn Knox, PT, DPT
• Koop Physical Therapy
• Niki L Koop, P.T.
• Kathryn J Kotrla, M.D.
• Christina Marie Kumar, MSED, CDA, RDH, RN
• Shelby Kurz, BSN, RN, NC-BC

• Family Medicine Physician in Leander, TX
• Providers in Leander, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; 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.