Individual provider Active NPI

Krishnamani Chinnasamy, M.D.

  • Internal Medicine Physician
  • High Point, NC
National Provider Identifier
1497150114
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2015-01642 Issued in NC
Practice address
1580 Skeet Club Rd
High Point, NC 27265-9530
Phone
(336) 883-0029
NPI assigned
Oct 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X 2015-01642 NC
Internal Medicine Physician 207R00000X 2015-01642 NC Primary

Addresses

Primary practice location

1580 Skeet Club Rd
High Point, NC 27265-9530

Mailing address

645 N Main St
High Point, NC 27260-5017
Phone (336) 883-0029

Other identifiers 1

IdentifierTypeStateIssuer
1497150114MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160630001667 NC Practitioner - Internal Medicine 1254623838
I20210429002252 TX Practitioner - Internal Medicine 1254623838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.84 of 100Reported as group
Quality
70.27
Promoting interoperability
98
Improvement activities
40
Cost
77.52

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2015-01642NCMDPain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Salma Mazhar M.D. P.a. Internal Medicine CurrentSince Mar 15, 2021 Accepting new patients
Bethany Medical Center Internal Medicine Past Accepting new patients

Locations

1210 N Galloway Ave
Mesquite, TX 75149
Phone (972) 216-5152

Interoperability endpoints

  • Direct secure messaging: krishnamanichinnasamy@bethanymed.allscriptsdirect.net

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1414022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1497150114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 N MAIN ST",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272605017",
            "telephone_number": "336-883-0029",
            "fax_number": "336-883-0867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 SKEET CLUB RD",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272659530",
            "telephone_number": "336-883-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHINNASAMY",
        "first_name": "KRISHNAMANI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-23",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NC",
            "license": "2015-01642",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2015-01642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497150114",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

Verify at the official NPI Registry.