Individual provider Active NPI

Mythili Paladugu, MD

  • Anesthesiology Physician
  • Fort Worth, TX
National Provider Identifier
1528139060
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
M6326 Issued in TX
Practice address
851 W Terrell Ave
Fort Worth, TX 76104-3161
Phone
(817) 332-8346
Fax
(817) 332-1723
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebology Physician 202K00000X M6326 TX
Anesthesiology Physician 207L00000X M6326 TX Primary

Addresses

Primary practice location

851 W Terrell Ave
Fort Worth, TX 76104-3161

Mailing address

PO Box 33434
Fort Worth, TX 76162-3434
Phone (817) 332-8346

Other identifiers 1

IdentifierTypeStateIssuer
197922103MedicaidTX

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
I20081106000239 TX Practitioner - AnesthesiologyPractitioner - Peripheral Vascular Disease 7719937549 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Peripheral Vascular Disease
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vascular and Vein Center, PAGroup PAC ID 2668531401, 3 clinicians

Practice addresses (Care Compare)

851 W Terrell Ave
Fort Worth, TX 76104-3161
Phone 8173328346111

Hospital & facility affiliations

  • Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135

Merit-based Incentive Payment System (MIPS)

Final score
99.6 of 100Reported as group
Quality
98.3
Improvement activities
40
Cost
80.04

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal156

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vascular and Vein Center PA CurrentSince Feb 1, 2013 Accepting new patients
Roswell Clinic Corp Past Accepting new patients

Locations

6100 Harris Pkwy
Ste 270
Fort Worth, TX 76132
Phone (817) 336-6012

1325 Pennsylvania Ave
Ste 440
Fort Worth, TX 76104
Phone (817) 685-4485

8704 Medical City Way
Fort Worth, TX 76177
Phone (817) 332-8346

851 W Terrell Ave
Ft Worth, TX 76104
Phone (817) 332-8346

150 River North Blvd
Stephenville, TX 76401
Phone (254) 965-9729

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJGAA

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 1

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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1528139060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33434",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761623434",
            "telephone_number": "817-332-8346",
            "fax_number": "817-332-1723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 W TERRELL AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043161",
            "telephone_number": "817-332-8346",
            "fax_number": "817-332-1723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALADUGU",
        "first_name": "MYTHILI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "TX",
            "license": "M6326",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "M6326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197922103",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.