Individual provider Active NPI

Dayakar Kamjula Reddy, M.D.

  • Internal Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1417026675
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
U5498 Issued in TX
Practice address
1301 Pennsylvania Ave
Fort Worth, TX 76104-2122
Phone
(817) 250-2000
NPI assigned
Nov 6, 2006
Last updated
Apr 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X U5498 TX Primary
Internal Medicine Physician 207R00000X 242095 NY
Hospitalist Physician 208M00000X 242095 NY
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 242095 NY

Addresses

Primary practice location

1301 Pennsylvania Ave
Fort Worth, TX 76104-2122

Mailing address

6716 Palermo TRL
Lewisville, TX 75077-8505
Phone (607) 377-4573

Other practice location 1

602 Ivy St
Elmira, NY 14905-1646
Phone (607) 735-4633

Other practice location 2

600 Roe Ave
Elmira, NY 14905-1629
Phone (607) 737-7770

Other identifiers 2

IdentifierTypeStateIssuer
02830106MedicaidNY
103154200MedicaidPA

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
I20230831003332 TX Practitioner - Internal Medicine 5799883484 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2001
Medicare assignment
May accept Medicare assignment
Group practices
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians
Aspen Medical Home LLCGroup PAC ID 3375086283, 3 clinicians

Practice addresses (Care Compare)

1300 W Terrell Ave
Suite K230
Fort Worth, TX 76104-3104
Phone (817) 250-7240

314 W Main St
Lewisville, TX 75057-3866
Phone (972) 215-8885

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
U5498TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Virtual Care CurrentSince Mar 1, 2024 Accepting new patients
Texas Health Physicians Group Internal Medicine CurrentSince Sep 1, 2023 Accepting new patients
Texas Health Physicians Group Current Accepting new patients
Texas Health Physicians Group CurrentSince Sep 1, 2023 Accepting new patients
Aspen Medical Home LLC Hospice and Palliative Medicine CurrentSince Apr 25, 2024 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Nov 1, 2023 Accepting new patients
Texas Health Virtual Care Internal Medicine CurrentSince Mar 1, 2024 Accepting new patients
Texas Health Presbyterian Hospital Denton Past Accepting new patients
Texas Health Physicians Group Internal Medicine Past Accepting new patients
Texas Health Harris Methodist Hospital Fort Worth Past Accepting new patients
Fort Edward Rescue Squad Inc Past Accepting new patients
Ny Acute Care Specialists PC Hospitalist Past Accepting new patients

Locations

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

4333 N Josey Ln
Ste 104
Carrollton, TX 75010
Phone (972) 394-4500

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

8200 Walnut Hill Ln
Fl 9
Dallas, TX 75231
Phone (214) 345-8001

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

1275 W Terrell Ave
Ste 200
Fort Worth, TX 76104
Phone (817) 250-7035

1300 W Terrell Ave
Ste K230
Fort Worth, TX 76104
Phone (817) 250-1815

1301 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 250-2000

314 W Main St
Lewisville, TX 75057
Phone (972) 215-8885

341 Wheatfield Dr
Ste 100
Sunnyvale, TX 75182
Phone (972) 329-1996

Interoperability endpoints

  • FHIR API: https://epproxy.texashealth.org/FHIR/api/FHIR/DSTU2/
  • FHIR API: https://fhir4.healow.com/fhir/r4/BIDHDD/Endpoint/BIDHDD

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Crossbridge HospiceIrving, TX, CCN 671633 Hospice Contracted Managing Employee Jun 16, 2025
Aspen Hospice Care IncLewisville, TX, CCN 671734 Hospice Contracted Managing Employee Apr 12, 2024

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 12

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.

Hospital & facility affiliations 6

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": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1417026675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6716 PALERMO TRL",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750778505",
            "telephone_number": "607-377-4573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PENNSYLVANIA AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042122",
            "telephone_number": "817-250-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "602 Ivy St",
            "address_purpose": "LOCATION",
            "city": "Elmira",
            "state": "NY",
            "postal_code": "149051646",
            "country_code": "US",
            "telephone_number": "607-735-4633",
            "fax_number": "607-735-4628",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 Roe Ave",
            "address_purpose": "LOCATION",
            "city": "Elmira",
            "state": "NY",
            "postal_code": "149051629",
            "country_code": "US",
            "telephone_number": "607-737-7770",
            "fax_number": "607-271-3686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REDDY",
        "first_name": "DAYAKAR",
        "middle_name": "KAMJULA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "U5498",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "242095",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "242095",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NY",
            "license": "242095",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02830106",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103154200",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.