Padmavathamma Pothala, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

L0909 Issued in TX

Practice address

1009 E 40TH Street
Suite 300B
Austin, TX 78751-4812

Phone

(512) 482-8280

Fax

(512) 482-9457

NPI assigned

Oct 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ipc Healthcare Services of Texas PLLCGroup PAC ID 3971824939, 184 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Round Rock Medical Center Hospital, Round Rock, TX, CCN 450718
• St David's Medical Center Hospital, Austin, TX, CCN 450431

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Ipc Healthcare Services of Texas, PLLC

  • Hospitalist Physician
  • San Antonio, TX
  • NPI 1023403011

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Lonestar Hospital Medicine Associates, PA

  • Hospitalist Physician
  • Mansfield, TX
  • NPI 1518237429

  Internal Medicine

  Medicare reassignment NPD
• Lonestar Pat Associates PA

  • Hospitalist Physician
  • Round Rock, TX
  • NPI 1811594203

  Internal Medicine

  Medicare reassignment NPD
• Michael L Gutierrez MD PA

  • Medical Specialty Clinic/Center
  • Austin, TX
  • NPI 1356749642
  NPD (past)
• St Davids Healthcare Partnership LP LLP

  dba Round Rock Medical Center

  • General Acute Care Hospital
  • Round Rock, TX
  • NPI 1649223645
  NPD (past)
• Wells Branch Internal Medicine, P.a.

  • Internal Medicine Physician
  • Austin, TX
  • NPI 1316131758
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Davids Healthcare Partnership LP LLP

  dba Round Rock Medical Center

  • General Acute Care Hospital
  • Round Rock, TX
  • NPI 1649223645
  Care Compare affiliation
• St. Davids Healthcare Partnership, L.P., LLP

  dba Heart Hospital of Austin

  • General Acute Care Hospital
  • Austin, TX
  • NPI 1720033947
  Care Compare affiliation

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258934400000",
    "number": "1639250392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 200009",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787200009",
            "telephone_number": "512-482-8280",
            "fax_number": "512-482-9457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 E 40TH STREET",
            "address_2": "SUITE 300B",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787514812",
            "telephone_number": "512-482-8280",
            "fax_number": "512-482-9457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTHALA",
        "first_name": "PADMAVATHAMMA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2009-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L0909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146623702",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110238080",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0082HO",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alla Postelnik
• Sara Beth Postma, MA, LPC
• Kaylee Marie Poston, PA
• Elizaveta Potapenko, PSY.D.
• Roy Keith Poth, M.D.
• Austin Potter
• Elisabeth H. Potter, MD
• Jennifer Potter, PHARMD
• Laura M Potter, MSW
• Marimikel Potter, RN-BSN, LM, CPM

• Internal Medicine Physician in Austin, TX
• Providers in Austin, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2009; 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.