Individual provider Active NPI

Chandra Krishnan, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Austin, TX
National Provider Identifier
1679763833
Registry record updated Sep 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
N5165 Issued in TX
Practice address
3445 Executive Center Drive
Suite 250
Austin, TX 78731-1678
Phone
(512) 579-4000
Fax
(512) 439-2814
NPI assigned
Jul 25, 2007
Last updated
Sep 28, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A92611 CA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X N5165 TX Primary

Addresses

Primary practice location

3445 Executive Center Drive
Suite 250
Austin, TX 78731-1678

Mailing address

3445 Executive Center Drive
Suite 250
Austin, TX 78731-1678
Phone (512) 579-4000

Other identifiers 1

IdentifierTypeStateIssuer
281820503MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, DE2 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

Enrollment IDStateProvider typePAC IDDetails
I20101021000455 TX Practitioner - Pathology 4789877861 Reassigns benefits to 1 organization
I20260625002476 DE Practitioner - Pathology 4789877861

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Arizona College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1201 W 38TH St
Austin, TX 78705-1006
Phone (512) 579-4000

1201 W Louis Henna Blvd
Round Rock, TX 78681-2301
Phone (512) 579-4000

3445 Executive Ctr Dr
Suite 250
Austin, TX 78731-1678
Phone (512) 579-4000

424 Savannah Rd
Lewes, DE 19958-1462
Phone (512) 579-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A92611CAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hurt, Jacknow, Moore, Connor, Wells, Michels, Yurco, Listrom & Huang Anatomic Pathology & Clinical Pathology CurrentSince Nov 1, 2012 Accepting new patients
Travis Pathology Associates PA Anatomic Pathology & Clinical Pathology Past Accepting new patients
Austin Pathology Associates Anatomic Pathology & Clinical Pathology Past Accepting new patients
Austin Pathology Associates Anatomic Pathology & Clinical Pathology Past Accepting new patients
Travis Pathology Associates PA Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

424 Savannah Rd
Lewes, DE 19958
Phone (302) 441-1078

19161 Healthy Way
Rehoboth Beach, DE 19971
Phone (302) 703-3630

3445 Executive Center Dr
Ste 250
Austin, TX 78731
Phone (512) 339-1275

Organizations & group practices 5

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 2

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": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443398400000",
    "number": "1679763833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3445 EXECUTIVE CENTER DRIVE",
            "address_2": "SUITE 250",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787311678",
            "telephone_number": "512-579-4000",
            "fax_number": "512-439-2814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3445 EXECUTIVE CENTER DRIVE",
            "address_2": "SUITE 250",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787311678",
            "telephone_number": "512-579-4000",
            "fax_number": "512-439-2814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISHNAN",
        "first_name": "CHANDRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-25",
        "last_updated": "2015-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A92611",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "N5165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "281820503",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.