Christodoulos S Christodoulou, M.D.

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

P1628 Issued in TX

Practice address

2141 Hamilton Way
San Angelo, TX 76904-6831

Phone

(325) 747-2480

NPI assigned

Jul 2, 2012

Last updated

Mar 21, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Allergy/Immunology

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Shannon ClinicGroup PAC ID 0840103727, 550 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Shannon Medical Center Hospital, San Angelo, TX, CCN 450571

Merit-based Incentive Payment System (MIPS)

Final score

82.63 of 100Reported as group

Quality

78.21

Promoting interoperability

96

Improvement activities

40

Cost

67.22

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cchristodoulou54009@shannonhealth.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.

• Shannon Clinic

  • Family Medicine Physician
  • San Angelo, TX
  • NPI 1770587149

  Allergy & Immunology

  Medicare reassignment Care Compare group NPD
• Medcare Associates, P.a.

  • Internal Medicine Physician
  • Bandera, TX
  • NPI 1215025598
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Shannon Medical Center

  • General Acute Care Hospital
  • San Angelo, TX
  • NPI 1992707228
  Care Compare affiliation

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

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1700140969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 HIGHWAY 16 S.",
            "city": "BANDERA",
            "state": "TX",
            "postal_code": "78009",
            "telephone_number": "830-796-7713",
            "fax_number": "830-796-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2141 HAMILTON WAY",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046831",
            "telephone_number": "325-747-2480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1050 Highway 16 S.",
            "address_purpose": "LOCATION",
            "city": "Bandera",
            "state": "TX",
            "postal_code": "78009",
            "country_code": "US",
            "telephone_number": "830-796-7713",
            "fax_number": "830-796-7744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHRISTODOULOU",
        "first_name": "CHRISTODOULOS",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-02",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "TX",
            "license": "P1628",
            "primary": false
        },
        {
            "code": "207KI0005X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Clinical & Laboratory Immunology",
            "state": "TX",
            "license": "P1628",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "TX",
            "license": "P1628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rangarao Chilukuri, MD
• Cornelius W. Chinn, MD
• Chiropractic of San Angelo, PC (stotts chiropractic)
• Douglas Franklin Chitsey, D.D.S.
• Kendra Ann Chowning, DC
• Lisamaria Marlena Cinco-Gonzales, SLP
• City of San Angelo
• City of San Angelo
• City of San Angelo (City - County Primary Healthcare Clinic)
• Jack Clifton Clanton III, PTA

• Allergy & Immunology Physician in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Allergy & Immunology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; 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.