Individual provider Active NPI

Vinay Punnam, MBBS

  • Internal Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1619139060
Registry record updated Jan 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
P6064 Issued in TX
Practice address
10864 Texas Health TRL
Fort Worth, TX 76244-4897
Phone
(682) 212-3160
Fax
(682) 212-9301
NPI assigned
Jun 26, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 003114 NY
Internal Medicine Physician 207R00000X P6064 TX Primary

Addresses

Primary practice location

10864 Texas Health TRL
Fort Worth, TX 76244-4897

Mailing address

10864 Texas Health TRL
Fort Worth, TX 76244-4897
Phone (682) 212-3160

Other identifiers 1

IdentifierTypeStateIssuer
338423201MedicaidTX

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
I20140820002077 TX Practitioner - Internal Medicine 4385719624 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

10864 Texas Health TRL
Fort Worth, TX 76244-4897
Phone (682) 212-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P6064TXMDInternal Medicine Physician
003114NYMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Virtual Care Internal Medicine CurrentSince Mar 1, 2024 Accepting new patients
Texas Health Virtual Care CurrentSince Mar 1, 2024 Accepting new patients
Texas Health Physicians Group Internal Medicine CurrentSince Jul 1, 2014 Accepting new patients
Texas Health Physicians Group Current Accepting new patients
Texas Health Physicians Group CurrentSince Jul 1, 2014 Accepting new patients
Texas Health Harris Methodist Hospital Alliance Past Accepting new patients

Locations

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

4333 N Josey Ln
Ste 104
Carrollton, TX 75010
Phone (972) 394-4500

8200 Walnut Hill Ln
Fl 9
Dallas, TX 75231
Phone (214) 345-8001

10864 Texas Health Trl
Fort Worth, TX 76244
Phone (682) 212-2000

341 Wheatfield Dr
Ste 100
Sunnyvale, TX 75182
Phone (972) 329-1996

Interoperability endpoints

  • Direct secure messaging: vpunnam445478@direct.texashealth.org
  • FHIR API: https://epproxy.texashealth.org/FHIR/api/FHIR/DSTU2/

Organizations & group practices 6

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 2

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": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421884800000",
    "number": "1619139060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10864 TEXAS HEALTH TRL",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762444897",
            "telephone_number": "682-212-3160",
            "fax_number": "682-212-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10864 TEXAS HEALTH TRL",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762444897",
            "telephone_number": "682-212-3160",
            "fax_number": "682-212-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUNNAM",
        "first_name": "VINAY",
        "name_prefix": "Dr.",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-26",
        "last_updated": "2015-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "003114",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "P6064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "338423201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.