Individual provider Active NPI

Kandaswamy Jayaraj, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Beaumont, TX
National Provider Identifier
1447258850
Registry record updated Aug 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
L6963 Issued in TX
Practice address
3440 Fannin St
Beaumont, TX 77701-3842
Phone
(409) 833-6900
Fax
(409) 833-6908
NPI assigned
Jul 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X L6963 TX Primary

Addresses

Primary practice location

3440 Fannin St
Beaumont, TX 77701-3842

Mailing address

PO Box 12499
Beaumont, TX 77726-2499
Phone (409) 833-6900

Other identifiers 1

IdentifierTypeStateIssuer
168936601MedicaidTX

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
I20041021000159 TX Practitioner - Endocrinology 1557322831 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Duke University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kandaswamy Jayaraj MD PAGroup PAC ID 5799746079, 3 clinicians

Practice addresses (Care Compare)

3440 Fannin St
Beaumont, TX 77701-3842
Phone (409) 833-6900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.14 of 100Reported as individual
Quality
82.28
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kandaswamy Jayaraj MD PA Endocrinology, Diabetes & Metabolism CurrentSince Aug 8, 2004 Accepting new patients

Locations

3440 Fannin St
Beaumont, TX 77701
Phone (409) 833-6900

3030 North St
Ste 310
Beaumont, TX 77702
Phone (248) 802-9174

Interoperability endpoints

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

Organizations & group practices 1

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 4

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": "1120867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251676800000",
    "number": "1447258850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12499",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777262499",
            "telephone_number": "409-833-6900",
            "fax_number": "409-833-6908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 FANNIN ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777013842",
            "telephone_number": "409-833-6900",
            "fax_number": "409-833-6908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAYARAJ",
        "first_name": "KANDASWAMY",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-09",
        "last_updated": "2009-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "TX",
            "license": "L6963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168936601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.