NPIMap

Individual provider Active NPI

Manoj Donthineni, M.D.

  • Internal Medicine Physician
  • Garland, TX
National Provider Identifier
1497708093
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M5692 Issued in TX
Practice address
700 Walter Reed Blvd
Suite # 204
Garland, TX 75042-3701
Phone
(972) 487-5462
Fax
(972) 487-5277
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2023

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 M5692 TX Primary

Addresses

Primary practice location

700 Walter Reed Blvd
Suite # 204
Garland, TX 75042-3701

Mailing address

700 Walter Reed Blvd
Suite # 204
Garland, TX 75042-3701
Phone (972) 487-5462

Other identifiers 1

IdentifierTypeStateIssuer
1868150-02MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mdonthineni225473@direct.sw.org

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
I20070731000518 TX Practitioner - Internal Medicine 1951400688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

4001 Worth St
Dallas, TX 75246-1608

6800 Scenic Dr
Suite 1071
Rowlett, TX 75088-4552
Phone (972) 535-2946

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M5692TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network Internal Medicine Current Accepting new patients
Primamed Physicians PLLC PastSince Feb 9, 2025 Accepting new patients
Primamed Physicians PLLC Past Accepting new patients
Lake Pointe Operating Company, LLC Past Accepting new patients
Boppana Primary Care Clinic, PLLC Internal Medicine Past Accepting new patients

Locations

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

Interoperability endpoints

  • Direct secure messaging: mdonthineni225473@direct.sw.org

Organizations & group practices 5

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 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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1497708093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 WALTER REED BLVD",
            "address_2": "SUITE # 204",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750423701",
            "telephone_number": "972-487-5462",
            "fax_number": "972-487-5277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 WALTER REED BLVD",
            "address_2": "SUITE # 204",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750423701",
            "telephone_number": "972-487-5462",
            "fax_number": "972-487-5277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONTHINENI",
        "first_name": "MANOJ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M5692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1868150-02",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdonthineni225473@direct.sw.org",
            "affiliation": "N",
            "address_1": "6800 Scenic Dr Ste 1071",
            "city": "Rowlett",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750884552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

Verify at the official NPI Registry.