Individual provider Active NPI

Kanchandip K. Koshy

  • Family Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1477193159
Registry record updated Mar 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP144019 Issued in TX
Practice address
2280 Inwood Rd
Dallas, TX 75235-7321
Phone
(214) 645-8525
NPI assigned
Jan 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP144019 TX Primary

Addresses

Primary practice location

2280 Inwood Rd
Dallas, TX 75235-7321

Mailing address

2280 Inwood Rd
Dallas, TX 75235-7321
Phone (214) 645-8525

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200420000017 TX Practitioner - Nurse Practitioner 9830529643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2280 Inwood Rd
Dallas, TX 75235-7321
Phone (214) 645-8525

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Mar 16, 2020 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Mar 16, 2020 Accepting new patients

Locations

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

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

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 3

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 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": "1578614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583625600000",
    "number": "1477193159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2280 INWOOD RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357321",
            "telephone_number": "214-645-8525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2280 INWOOD RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357321",
            "telephone_number": "214-645-8525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSHY",
        "first_name": "KANCHANDIP",
        "middle_name": "K.",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-10",
        "last_updated": "2020-03-08",
        "certification_date": "2020-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP144019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.