Individual provider Active NPI

Kishori Venkata Laxmi Somyreddy, M.D.

  • Specialist
  • Irving, TX
National Provider Identifier
1407073216
Registry record updated Apr 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
R9692 Issued in TX
Practice address
1110 Cottonwood LN Ste 205
Irving, TX 75038-6111
Phone
(214) 727-8900
NPI assigned
Apr 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 14852 NH
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X R9692 TX Primary

Addresses

Primary practice location

1110 Cottonwood LN Ste 205
Irving, TX 75038-6111

Mailing address

1110 Cottonwood LN Ste 205
Irving, TX 75038-6111
Phone (214) 727-8900

Other identifiers 1

IdentifierTypeStateIssuer
30209662MedicaidNH

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL ShareFile Health Information Exchange (HIE)

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200501001985 TX Practitioner - Neurology 8325162563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neurology Associates of Texas, PLLCGroup PAC ID 8921439118, 2 clinicians

Practice addresses (Care Compare)

1110 Cottonwood LN
Suite 205
Irving, TX 75038-6111
Phone (214) 727-8900

Hospital & facility affiliations

  • Baylor Scott & White Medical Center at Irving Hospital, Irving, TX, CCN 450079
  • Baylor Scott & White Institute for Rehabilitation Inpatient rehabilitation facility, Dallas, TX, CCN 453036

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14852NHMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neurology Associates of Texas, PLLC Specialist CurrentSince Apr 22, 2020 Accepting new patients

Locations

1110 Cottonwood Ln
Ste 205
Irving, TX 75038
Phone (214) 727-8900

Organizations & group practices 1

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 3

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": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586736000000",
    "number": "1407073216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 COTTONWOOD LN STE 205",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750386111",
            "telephone_number": "214-727-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 COTTONWOOD LN STE 205",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750386111",
            "telephone_number": "214-727-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMYREDDY",
        "first_name": "KISHORI",
        "middle_name": "VENKATA LAXMI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NH",
            "license": "14852",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "R9692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30209662",
            "state": "NH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "ShareFile",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1110 Cottonwood Ln Ste 205",
            "city": "Irving",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750386111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.