Individual provider Active NPI

Niranjan Reddy Banda, M.D.

  • Internal Medicine Physician
  • Irving, TX
National Provider Identifier
1659608255
Registry record updated Apr 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
R0994 Issued in TX
Practice address
1111 Kinwest Pkwy Ste 140
Irving, TX 75063-3420
Phone
(214) 550-6664
NPI assigned
Nov 3, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R0994 TX Primary

Addresses

Primary practice location

1111 Kinwest Pkwy Ste 140
Irving, TX 75063-3420

Mailing address

1111 Kinwest Pkwy Ste 140
Irving, TX 75063-3420
Phone (214) 550-6664

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
I20170615001942 TX Practitioner - Internal Medicine 4284804543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1111 Kinwest Pkwy
Suite 140
Irving, TX 75063-3420
Phone (214) 550-6664

11801 S Fwy
Burleson, TX 76028-7021
Phone (817) 293-9110

12001 S Fwy
Suite 301
Burleson, TX 76028-7215
Phone (214) 550-6664

2010 Valley View LN
Suite 250
Farmers Branch, TX 75234-8900
Phone (214) 550-6664

Hospital & facility affiliations

  • Texas Health Huguley Hospital Fort Worth South Hospital, Fort Worth, TX, CCN 450677

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R0994TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Star Ed PLLC CurrentSince Jun 14, 2020 Accepting new patients
Banner Sun City Medical Group Past Accepting new patients

Organizations & group practices 3

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 3

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": "1257206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743811200000",
    "number": "1659608255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 KINWEST PKWY STE 140",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750633420",
            "telephone_number": "214-550-6664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 KINWEST PKWY STE 140",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750633420",
            "telephone_number": "214-550-6664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANDA",
        "first_name": "NIRANJAN",
        "middle_name": "REDDY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-03",
        "last_updated": "2025-04-05",
        "certification_date": "2025-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "R0994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.