Sreedevi Kodali, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

M6238 Issued in TX

Practice address

5013 Heritage Ave Ste 100
Colleyville, TX 76034-5990

Phone

(817) 868-1616

NPI assigned

Apr 23, 2007

Last updated

Aug 22, 2013By 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 1

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

Dermatology

Education

Columbia University College of Physicians and Surgeons, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sreedevi Kodali, M.D., PLLCGroup PAC ID 7810031747, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sreedevi Kodali, M.D., PLLC

  • Medical Specialty Clinic/Center
  • Colleyville, TX
  • NPI 1548597289
  Medicare reassignment Care Compare group NPD Authorized official
• Epiphany Dermatology PA

  • Dermatology Physician
  • Waco, TX
  • NPI 1043615263
  NPD (past)

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377129600000",
    "number": "1649498544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5013 HERITAGE AVE STE 100",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "760345990",
            "telephone_number": "817-868-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5013 HERITAGE AVE STE 100",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "760345990",
            "telephone_number": "817-868-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KODALI",
        "first_name": "SREEDEVI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2013-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "M6238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher King, DDS
• Tamra Renee King, MS,LPC ASSOCIATE
• Kingsbrook Jewish Medical Center
• Karen Kinman, PH.D., RN, LMFT
• Kailey Klatt, DPT
• Matthew Krall, DPT
• Susan Kay Krall, PHYSICAL THERAPIST
• Christine Michelle Kratch, FNP-C
• Bryan H Labus, DC
• Hilary Lai, L.AC., PH.D.

• Dermatology Physician in Colleyville, TX
• Providers in Colleyville, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2013; 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.