Individual provider Active NPI

Karthik Yeruva, MD

  • Internal Medicine Physician
  • Vicksburg, MS
National Provider Identifier
1427540129
Registry record updated May 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
27719 Issued in MS
Practice address
2100 Highway 61 N
Vicksburg, MS 39183-8211
Phone
(601) 883-5946
NPI assigned
May 30, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2022

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 27719 MS Primary

Addresses

Primary practice location

2100 Highway 61 N
Vicksburg, MS 39183-8211

Mailing address

PO Box 321359
Flowood, MS 39232-1359
Phone (601) 936-1395

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
I20240415001635 TX Practitioner - Internal Medicine 3870918378 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Granbury Hospital-Based Professional ServicesGroup PAC ID 3971940966, 69 clinicians

Practice addresses (Care Compare)

1310 Paluxy Rd
Granbury, TX 76048-5655
Phone (817) 573-2273

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
43.55 of 100Reported as group
Quality
7.63
Improvement activities
40
Cost
81.19

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Granbury Hospital-Based Professional Services CurrentSince Mar 5, 2024 Accepting new patients
Granbury Hospital Corporation Past Accepting new patients

Locations

1310 Paluxy Rd
Granbury, TX 76048
Phone (817) 573-2273

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 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": "1527638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1427540129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 321359",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392321359",
            "telephone_number": "601-936-1395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 HIGHWAY 61 N",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391838211",
            "telephone_number": "601-883-5946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YERUVA",
        "first_name": "KARTHIK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-30",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "27719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vicksburg, MS

Sources for this page

Verify at the official NPI Registry.