Mythili Kasturi, M.D

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

Q5831 Issued in TX

Practice address

Austin Regional Clinic
12779 TX- 29
Liberty Hill, TX 78642

Phone

(512) 778-7003

NPI assigned

Feb 27, 2008

Last updated

May 23, 2024By 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 3

Addresses

Other names 1

• Mythili Kommirshetty Former name

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

Family Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Austin Regional Clinic PAGroup PAC ID 3072507789, 398 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mkasturi34306@arcmd.direct-ci.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.

• Austin Regional Clinic, PA

  • Family Medicine Physician
  • Austin, TX
  • NPI 1821157579
  Medicare reassignment Care Compare group NPD
• LHP Texas MD Services Inc

  dba Wellstone Health Partners

  • General Practice Physician
  • Harker Heights, TX
  • NPI 1841562667

  Family Medicine

  Medicare reassignment NPD
• Austin Regional Clinic, PA

  dba ARC- Center Street

  • Durable Medical Equipment & Medical Supplies
  • Kyle, TX
  • NPI 1235746413
  NPD

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1669641254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6210 E HWY 290 STE 240",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787231144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AUSTIN REGIONAL CLINIC",
            "address_2": "12779 TX- 29",
            "city": "LIBERTY HILL",
            "state": "TX",
            "postal_code": "78642",
            "telephone_number": "512-778-7003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 W Central Texas Expy Ste 125",
            "address_purpose": "LOCATION",
            "city": "Harker Heights",
            "state": "TX",
            "postal_code": "765481996",
            "country_code": "US",
            "telephone_number": "254-618-1050",
            "fax_number": "254-618-1058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KASTURI",
        "first_name": "MYTHILI",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-27",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301088208",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "55672",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q5831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MYTHILI",
            "last_name": "KOMMIRSHETTY",
            "credential": "M.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Family Medicine Physician in Liberty Hill, TX
• Providers in Liberty Hill, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; 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.