Kumara S Peddamatham, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

G4378 Issued in TX

Practice address

1601 Main St
Ste 401
Richmond, TX 77469-3244

Phone

(281) 342-9530

Fax

(281) 342-9564

NPI assigned

Jun 24, 2005

Last updated

Aug 14, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: kupedd50@direct.uspi.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.

• Kumara S. Peddamatham, MD, PA

  • Gastroenterology Physician
  • Richmond, TX
  • NPI 1073838314
  Authorized official Same address or phone
• Richmond Gastroenterology Associates, PLLC

  • Gastroenterology Physician
  • Richmond, TX
  • NPI 1174848428
  Authorized official Same address or phone
• Citizens Medical Center County of Victoria

  • General Acute Care Hospital
  • Victoria, TX
  • NPI 1124052162
  NPD (past)

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313280000000",
    "number": "1659377547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 MAIN ST",
            "address_2": "STE 401",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774693244",
            "telephone_number": "713-459-4326",
            "fax_number": "281-903-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 MAIN ST",
            "address_2": "STE 401",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774693244",
            "telephone_number": "281-342-9530",
            "fax_number": "281-342-9564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDDAMATHAM",
        "first_name": "KUMARA",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2011-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "G4378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "098552503",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00G84F",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "098552501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8CM672",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in Richmond, TX
• Providers in Richmond, TX by specialty
• Gastroenterology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.