NPIMap

Individual provider Active NPI

Sudha Rani Yanamandra, M.D.

  • Internal Medicine Physician
  • Longview, TX
National Provider Identifier
1497193304
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
Q7989 Issued in TX
Practice address
802 Medical Dr Ste 205
Longview, TX 75605-5208
Phone
(903) 291-6209
Fax
(903) 537-6995
NPI assigned
Jun 13, 2013
Last updated
Nov 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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 Q7989 TX Primary

Addresses

Primary practice location

802 Medical Dr Ste 205
Longview, TX 75605-5208

Mailing address

PO Box 19036
Belfast, ME 04915-4085
Phone (903) 381-7263

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sudha.yanamandra.1@16432.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161102002126 TX Practitioner - Internal Medicine 3476852575 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regional Clinics of LongviewGroup PAC ID 7214016559, 38 clinicians

Practice addresses (Care Compare)

1009 N 4TH St
Suite a
Longview, TX 75601-4768
Phone (903) 757-3808

5174 FM 1252
Kilgore, TX 75662-1961
Phone (903) 986-1901

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.53 of 100Reported as apm
Quality
79.07
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Clinics of Longview Internal Medicine CurrentSince Oct 3, 2016 Accepting new patients

Locations

1009 N 4th St
Ste A
Longview, TX 75601
Phone (903) 757-3808

707 Hollybrook Dr
Longview, TX 75605
Phone (903) 232-8501

707 Hollybrook Dr
Ste 500
Longview, TX 75605
Phone (903) 232-8276

707 Hollybrook Dr
Ste 504
Longview, TX 75605
Phone (903) 232-8501

802 Medical Cir
Ste 205
Longview, TX 75605
Phone (903) 291-6209

Interoperability endpoints

  • Direct secure messaging: sudha.yanamandra.1@16432.direct.athenahealth.com

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 6

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": "1371081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1497193304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19036",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154085",
            "telephone_number": "903-381-7263",
            "fax_number": "903-381-7269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 MEDICAL DR STE 205",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055208",
            "telephone_number": "903-291-6209",
            "fax_number": "903-537-6995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANAMANDRA",
        "first_name": "SUDHA RANI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-13",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "Q7989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sudha.yanamandra.1@16432.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "802 Medical Dr Ste 205",
            "city": "Longview",
            "state": "TX",
            "country_code": "US",
            "postal_code": "756055208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.