Jaya Bharathi Peddi, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

T9966 Issued in TX

Practice address

2801 Missouri Ave
Suite 7
Las Cruces, NM 88011-5075

Phone

(575) 521-8500

Fax

(575) 521-8400

NPI assigned

Sep 9, 2008

Last updated

Mar 9, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Internal Medicine

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kelsey-Seybold Medical Group, PLLCGroup PAC ID 9739093527, 941 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jpeddi55869@direct.kelsey-seybold.com

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.

• Kelsey-Seybold Medical Group, PLLC

  dba Kelsey Seybold Clinic

  • Multi-Specialty Clinic/Center
  • Houston, TX
  • NPI 1013915255

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Associated Cardiology Consultants of New Mexico

  • Cardiovascular Disease Physician
  • Las Cruces, NM
  • NPI 1609960624
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1629226113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 SHADOW CREEK PKWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847298",
            "telephone_number": "713-442-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 MISSOURI AVE",
            "address_2": "SUITE 7",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880115075",
            "telephone_number": "575-521-8500",
            "fax_number": "575-521-8400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2510 W Grand Pkwy N",
            "address_purpose": "LOCATION",
            "city": "Katy",
            "state": "TX",
            "postal_code": "774492853",
            "country_code": "US",
            "telephone_number": "713-442-4222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEDDI",
        "first_name": "JAYA",
        "middle_name": "BHARATHI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-09",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "BP10030961",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "T9966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peak Medical Las Cruces, LLC (Casa Del Sol Center)
• Emily Ruth Pearlstein, LMHC
• Andrew Stephen Pearson, MD
• Carlos Peay, C.PED
• Katherine Peck Louise Peck, RN, CNS, PNP
• Pediatric Behavioral Medicine, Inc
• Pediatric Dental Specialist of New Mexico LLC
• Elizabeth Pedraza
• Priscilla Pedraza, FNP-C
• Peds Tots to Teens LLC

• Internal Medicine Physician in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Internal Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.