Praveen K Tamirisa, MD

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

S2912 Issued in TX

Practice address

11803 South Fwy Ste 115
Burleson, TX 76028-7028

Phone

(817) 293-8441

Fax

(817) 293-8505

NPI assigned

Jun 9, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH, MI2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ptamirisa1538064@direct.texashealth.org

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.

• Promedica Northwest Ohio Cardiology Consultants, LLC

  • Cardiovascular Disease Physician
  • Toledo, OH
  • NPI 1780820555

  MI

  Medicare reassignment NPD
• The Toledo Hospital

  • General Acute Care Hospital
  • Toledo, OH
  • NPI 1407854771
  Medicare reassignment NPD
• Consultants in Laboratory Medicine of Greater Toledo

  • Anatomic Pathology & Clinical Pathology Physician
  • Toledo, OH
  • NPI 1982673372
  NPD
• Haematology-Oncology Associates of Ohio and Michigan PC

  • Hematology & Oncology Physician
  • Lambertville, MI
  • NPI 1841296605
  NPD
• Northwest Ohio Cardiology Consultants PC

  • Cardiovascular Disease Physician
  • Toledo, OH
  • NPI 1053341081
  NPD
• Promedica Northwest Ohio Cardiology Consultants, LLC

  • Cardiac Rehabilitation Registered Nurse
  • Toledo, OH
  • NPI 1649559394

  Cardiovascular Disease

  NPD
• The Toledo Hospital

  • Internal Medicine Physician
  • Sylvania, OH
  • NPI 1033546981
  NPD
• The Toledo Hospital

  • Community/Retail Pharmacy
  • Toledo, OH
  • NPI 1740217678
  NPD
• Heartplace, PLLC

  • Cardiovascular Disease Physician
  • Franklin, TN
  • NPI 1417117912
  NPD (past)
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Northwest Ohio Cardiology Consultants- PC

  • Specialist
  • Toledo, OH
  • NPI 1508030123
  NPD (past)

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1679577597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11803 SOUTH FWY STE 115",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760287028",
            "telephone_number": "817-293-8441",
            "fax_number": "817-293-8505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11803 SOUTH FWY STE 115",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760287028",
            "telephone_number": "817-293-8441",
            "fax_number": "817-293-8505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMIRISA",
        "first_name": "PRAVEEN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301077499",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35079630T",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MI",
            "license": "4301077499",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "S2912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2258971",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "P00711902",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zachary Sutton, DMD
• Julia Sweeney, RBT
• Synaptic Chiropractic PLLC
• Debra Tahmahkera, RNFA
• Patricia Talley, RPH
• Tarrant Anesthesia, PA
• Jay Tasker, PTA
• Steven Tate, D.D.S.
• Lisa Tatum
• Brittany Taylor

• Interventional Cardiology Physician in Burleson, TX
• Providers in Burleson, TX by specialty
• Interventional Cardiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.