Individual provider Active NPI

Chaitanya Venkata Tummala, MD

  • Infectious Disease Physician
  • Frisco, TX
National Provider Identifier
1518929959
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
L9525 Issued in TX
Practice address
4461 Coit Rd
Ste 409
Frisco, TX 75035-0526
Phone
(214) 396-8877
Fax
(214) 983-0983
NPI assigned
Apr 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X L9525 TX Primary

Addresses

Primary practice location

4461 Coit Rd
Ste 409
Frisco, TX 75035-0526

Mailing address

4461 Coit Rd Ste 409
Frisco, TX 75035-0526
Phone (214) 396-8877

Other identifiers 1

IdentifierTypeStateIssuer
172136703MedicaidTX

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
I20040615001850 TX Practitioner - Infectious DiseasePractitioner - Internal Medicine 7315921541 Reassigns benefits to 1 organization
Practice locations: Frisco, TX

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 1996
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4461 Coit Rd
Suite 409
Frisco, TX 75035-0526
Phone (214) 396-8877

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Chaitanya Tummala MD PA Infectious Disease CurrentSince Jun 29, 2017 Accepting new patients
I.D. Doctors Pharmacy Past Accepting new patients

Locations

4461 Coit Rd
Ste 409
Frisco, TX 75035
Phone (214) 396-8877

3901 W 15th St
Plano, TX 75075
Phone (972) 519-1115

Interoperability endpoints

  • Direct secure messaging: dmcctumma@yourcarecommunity.org

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1518929959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4461 COIT RD STE 409",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750350526",
            "telephone_number": "214-396-8877",
            "fax_number": "214-983-0983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4461 COIT RD",
            "address_2": "STE 409",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750350526",
            "telephone_number": "214-396-8877",
            "fax_number": "214-983-0983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUMMALA",
        "first_name": "CHAITANYA",
        "middle_name": "VENKATA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "TX",
            "license": "L9525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "172136703",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

Verify at the official NPI Registry.