Individual provider Active NPI

Manohar Yedulapuram, MD

  • Internal Medicine Physician
  • Plano, TX
National Provider Identifier
1407858426
Registry record updated Sep 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M1411 Issued in TX
Practice address
PO Box 260489
Plano, TX 75026-0489
Phone
(972) 943-9377
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M1411 TX Primary
Hospitalist Physician 208M00000X M1411 TX

Addresses

Primary practice location

PO Box 260489
Plano, TX 75026-0489

Mailing address

PO Box 260489
Plano, TX 75026-0489
Phone (214) 842-6449

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
I20060509000205 TX Practitioner - Internal Medicine 6608842497 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dallas Pulmonary and Critical Care PAGroup PAC ID 2163679200, 186 clinicians
Hospitalist Medicine Physicians of Texas - Burnet PLLCGroup PAC ID 1850831637, 76 clinicians

Practice addresses (Care Compare)

221 W Colorado Blvd
Suite 525
Dallas, TX 75208-2312
Phone 214960568175

5016 S US Hwy 75
Texoma Medical Center
Denison, TX 75020-4584
Phone (903) 416-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M1411TXMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Pulmonary & Critical Care PA CurrentSince Feb 22, 2024 Accepting new patients
Concord North Texas, PLLC CurrentSince Apr 16, 2019 Accepting new patients
Hospitalist Medicine Physicians of Texas - Burnet PLLC Internal Medicine CurrentSince Jul 24, 2024 Accepting new patients
Uhs of Texoma, Inc Past Accepting new patients
Columbia Medical Center of Plano Subsidiary LP Past Accepting new patients
Physicians and Allied Health Professionals Group, PA Internal Medicine Past Accepting new patients
T M Carr MD PC Past Accepting new patients

Locations

504 Lipscomb St
Bonham, TX 75418
Phone (903) 583-8585

221 W Colorado Blvd
Ste 525
Dallas, TX 75208
Phone (214) 956-4525

5016 US Highway 75
Denison, TX 75020
Phone (855) 222-9637

5605 N MacArthur Blvd
Ste 740
Irving, TX 75038
Phone 2149605681 ext. 75

1498 Pacific Ave
Ste 500
Tacoma, WA 98402
Phone (253) 682-6040

Interoperability endpoints

  • Direct secure messaging: myedulapur@yourcarecommunity.org

Organizations & group practices 7

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 2

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": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443571200000",
    "number": "1407858426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 260489",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750260489",
            "telephone_number": "214-842-6449",
            "fax_number": "214-975-1460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 260489",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750260489",
            "telephone_number": "972-943-9377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEDULAPURAM",
        "first_name": "MANOHAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2015-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M1411",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "M1411",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.