NPIMap

Individual provider Active NPI

Chaitanya Goud Bonda, M.D., MBBS

  • Neuromuscular Medicine (Psychiatry & Neurology) Physician
  • Bentonville, AR
National Provider Identifier
1659651552
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromuscular Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084N0008X
License
S8421 Issued in TX
Practice address
2900 Medical Center Pkwy
Ste 310
Bentonville, AR 72712-3204
Phone
(479) 553-3310
Fax
(479) 553-1947
NPI assigned
Aug 23, 2011
Last updated
Dec 10, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromuscular Medicine (Psychiatry & Neurology) Physician 2084N0008X S8421 TX Primary

Addresses

Primary practice location

2900 Medical Center Pkwy
Ste 310
Bentonville, AR 72712-3204

Mailing address

5375 Coit Rd
Ste 130
Frisco, TX 75035-4914
Phone (479) 553-3310

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address chaitanya.bonda.1@2229.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160817002118 AR Practitioner - NeurologyPractitioner - Psychiatry 5193010064 Reassigns benefits to 2 organizations
I20201221000635 TX Practitioner - Neurology 5193010064 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Louisville School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sheth, MD, P.a.Group PAC ID 1153411483, 24 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

5375 Coit Rd
Suite 130
Frisco, TX 75035-4910
Phone (214) 619-1910

5701 Virginia Pkwy
McKinney, TX 75071-5652
Phone (214) 592-0212

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Physicians LLC CurrentSince Jul 30, 2016 Accepting new patients
Northwest Physicians LLC CurrentSince Jul 30, 2016 Accepting new patients
Sheth, MD, P.a. Neurology CurrentSince Dec 1, 2020 Accepting new patients
Northwest Benton County Physician Services LLC CurrentSince Jul 30, 2016 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

2900 Medical Center Pkwy
Ste 310
Bentonville, AR 72712
Phone (479) 553-3310

101 Sun Meadow Dr
Centerton, AR 72719
Phone (479) 273-1426

601 W Maple Ave
Ste 403
Springdale, AR 72764
Phone (479) 750-2742

5375 Coit Rd
Ste 130
Frisco, TX 75035

Interoperability endpoints

  • Direct secure messaging: chaitanya.bonda@lsneuro.eclinicaldirectplus.com

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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": "1314057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1659651552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5375 COIT RD",
            "address_2": "STE 130",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750354914",
            "telephone_number": "479-553-3310",
            "fax_number": "479-553-1947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 MEDICAL CENTER PKWY",
            "address_2": "STE 310",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123204",
            "telephone_number": "479-553-3310",
            "fax_number": "479-553-1947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONDA",
        "first_name": "CHAITANYA",
        "middle_name": "GOUD",
        "name_prefix": "Dr.",
        "credential": "M.D., MBBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-23",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0008X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neuromuscular Medicine",
            "state": "TX",
            "license": "S8421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chaitanya.bonda.1@2229.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "address_1": "2900 Medical Center Pkwy",
            "address_2": "Ste 310",
            "city": "Bentonville",
            "state": "AR",
            "country_code": "US",
            "postal_code": "727123204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

Verify at the official NPI Registry.