Individual provider Active NPI

Ifeoma A. Kalu, M.D.

  • Internal Medicine Physician
  • Irving, TX
National Provider Identifier
1417150509
Registry record updated Feb 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
N6403 Issued in TX
Practice address
1901 North Mac Arthur Blvd
Irving, TX 76051
Phone
(972) 579-8485
NPI assigned
Jun 7, 2007
Last updated
Feb 21, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X N6403 TX Primary

Addresses

Primary practice location

1901 North Mac Arthur Blvd
Irving, TX 76051

Mailing address

1901 N Macarthur Blvd
Irving, TX 75061-2220
Phone (972) 579-8485

Other identifiers 2

IdentifierTypeStateIssuer
217216502MedicaidTX
2172165-01MedicaidTX

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
I20101129000169 TX Practitioner - Internal Medicine 8527254861 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fort Worth Institute of Medical Sciences LLCGroup PAC ID 4688021306, 17 clinicians

Practice addresses (Care Compare)

1023 Lipscomb St
Suite 200
Fort Worth, TX 76104-3102
Phone (972) 544-6600

1023 Lipscomb St
Suite 201
Fort Worth, TX 76104-3196
Phone (972) 544-6600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Siripurapu Associates PLLC Medical Associates of North Texas Internal Medicine CurrentSince Jul 1, 2019 Accepting new patients
Healthtexas Provider Network CurrentSince Aug 3, 2010 Accepting new patients
Lonestar Hospital Medicine Associates, PA Internal Medicine CurrentSince Oct 1, 2016 Accepting new patients
Healthtexas Provider Network Internal Medicine CurrentSince Aug 3, 2010 Accepting new patients
Suresh Kankanala M.D, P.a. Past Accepting new patients
Baylor All Saints Medical Center Past Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

1023 Lipscomb St
Ste 200
Fort Worth, TX 76104
Phone (972) 544-6600

5400 Clearfork Main St
Fort Worth, TX 76109
Phone (817) 433-7000

1901 N MacArthur Blvd
Irving, TX 75061
Phone (972) 484-5192

2700 E Broad St
Mansfield, TX 76063
Phone (682) 242-2000

2111 Fort Worth Hwy
Weatherford, TX 76086
Phone (817) 596-3700

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

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": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361404800000",
    "number": "1417150509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 N MACARTHUR BLVD",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750612220",
            "telephone_number": "972-579-8485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 NORTH MAC ARTHUR BLVD",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "76051",
            "telephone_number": "972-579-8485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALU",
        "first_name": "IFEOMA",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-07",
        "last_updated": "2013-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N6403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "217216502",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2172165-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.