Individual provider Active NPI

Mallikarjuna R. Mukka, M.D.

  • Infectious Disease Physician
  • Fort Worth, TX
National Provider Identifier
1487608923
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
L9822 Issued in TX
Practice address
6551 Harris Pkwy Ste 110
Fort Worth, TX 76132-6105
Phone
(817) 624-3500
Fax
(682) 708-7225
NPI assigned
May 20, 2006
Last updated
Jul 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X L9822 TX Primary
Internal Medicine Physician 207R00000X L9822 TX

Addresses

Primary practice location

6551 Harris Pkwy Ste 110
Fort Worth, TX 76132-6105

Mailing address

6551 Harris Pkwy Ste 110
Fort Worth, TX 76132-6105
Phone (817) 624-3500

Other identifiers 1

IdentifierTypeStateIssuer
167966404MedicaidTX

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
I20041026000871 TX Practitioner - Infectious DiseasePractitioner - Internal Medicine 2466413018 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 1996
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Mallikarjuna Mukka MD PAGroup PAC ID 9436222510, 7 clinicians

Practice addresses (Care Compare)

6551 Harris Pkwy
Suite 110
Fort Worth, TX 76132-6105
Phone (817) 624-3500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue53
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mallikarjuna Mukka MD PA Infectious Disease CurrentSince Jun 2, 2008 Accepting new patients

Locations

6551 Harris Pkwy
Ste 110
Fort Worth, TX 76132
Phone (817) 370-8833

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

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

Hospital & facility affiliations 5

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1487608923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6551 HARRIS PKWY STE 110",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761326105",
            "telephone_number": "817-624-3500",
            "fax_number": "682-708-7225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6551 HARRIS PKWY STE 110",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761326105",
            "telephone_number": "817-624-3500",
            "fax_number": "682-708-7225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKKA",
        "first_name": "MALLIKARJUNA",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "TX",
            "license": "L9822",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L9822",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167966404",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.