Individual provider Active NPI

Jaya D Bathina, MD

  • Cardiovascular Disease Physician
  • Fort Worth, TX
National Provider Identifier
1407086705
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
R5357 Issued in TX
Practice address
1400 S Main St FL 1
Fort Worth, TX 76104-4909
Phone
(817) 702-6926
NPI assigned
Jul 21, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD2015-0139 NM
Cardiovascular Disease Physician 207RC0000X MD2015-0139 NM
Cardiovascular Disease Physician 207RC0000X R5357 TX Primary

Addresses

Primary practice location

1400 S Main St FL 1
Fort Worth, TX 76104-4909

Mailing address

PO Box 732973
Dallas, TX 75373-6666
Phone (817) 702-2450

Other practice location 1

2200 W 21st St
Clovis, NM 88101-2011
Phone (575) 769-2141

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
I20220510001468 TX Practitioner - Cardiovascular Disease (Cardiology) 5799908463 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acclaim Physician Group IncGroup PAC ID 4587963582, 520 clinicians
Old McDonald Health Care Services PAGroup PAC ID 2163860750, 2 clinicians

Practice addresses (Care Compare)

1050 W Arkansas LN
Arlington, TX 76013-6308
Phone (817) 702-1100

1350 S Main St
Suite 1600
Fort Worth, TX 76104-7611
Phone (817) 702-9701

1350 S Main St FL
1 Healing Wings/Infectious Disease
Fort Worth, TX 76104-7611
Phone (817) 702-3701

1400 S Main St
Fort Worth, TX 76104-4909

1500 S Main St
Fort Worth, TX 76104-4917

1500 S Main St FL
1 Urgent Care Center
Fort Worth, TX 76104-4917
Phone (817) 702-1451

3200 W Euless Blvd
Euless, TX 76040-6253
Phone (817) 702-1100

4300 Punjab Way
Suite 160 Daffodil Primary Care and Cardio
Frisco, TX 75033-0382
Phone (469) 649-9968

Hospital & facility affiliations

  • JPS Health Network Hospital, Fort Worth, TX, CCN 450039

Merit-based Incentive Payment System (MIPS)

Final score
96.38 of 100Reported as group
Quality
80.41
Promoting interoperability
100
Improvement activities
40
Cost
78.69

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Acclaim Physician Group, Inc Internal Medicine CurrentSince Feb 28, 2022 Accepting new patients
Old McDonald Health Care Services PA Internal Medicine CurrentSince Mar 25, 2024 Accepting new patients

Locations

1050 W Arkansas Ln
Arlington, TX 76013
Phone (817) 277-6555

3200 W Euless Blvd
Euless, TX 76040
Phone (817) 702-6474

1350 S Main St
Fl 1
Fort Worth, TX 76104
Phone (817) 702-3701

1400 S Main St
Fl 1
Fort Worth, TX 76104
Phone (817) 702-6926

4300 Punjab Way
Ste 160
Frisco, TX 75033
Phone (469) 649-9968

200 W Magnolia Ave
Ste 201
Ft Worth, TX 76104
Phone (817) 702-2450

8720 Silverado Trl
Ste 3D
McKinney, TX 75070
Phone (972) 752-8118

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BCEGDD/Endpoint/BCEGDD

Organizations & group practices 2

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 1

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": "1248134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1407086705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 732973",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753736666",
            "telephone_number": "817-702-2450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S MAIN ST FL 1",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044909",
            "telephone_number": "817-702-6926"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 W 21st St",
            "address_purpose": "LOCATION",
            "city": "Clovis",
            "state": "NM",
            "postal_code": "881012011",
            "country_code": "US",
            "telephone_number": "575-769-2141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BATHINA",
        "first_name": "JAYA",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-21",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "MD2015-0139",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NM",
            "license": "MD2015-0139",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "R5357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.