NPIMap

Individual provider Active NPI

Madhava Agusala, M.D.

  • Cardiovascular Disease Physician
  • Odessa, TX
National Provider Identifier
1700915303
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
J1178 Issued in TX
Practice address
318 N Alleghaney Ave
Suite 402
Odessa, TX 79761-5052
Phone
(432) 337-2714
Fax
(432) 337-2726
NPI assigned
Mar 2, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X J1178 TX Primary

Addresses

Primary practice location

318 N Alleghaney Ave
Suite 402
Odessa, TX 79761-5052

Mailing address

318 N Alleghaney Ave
Suite 402
Odessa, TX 79761-5052
Phone (432) 337-2714

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090604000511 TX Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 5890605398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Big Bend Medical GroupGroup PAC ID 2163326281, 46 clinicians

Practice addresses (Care Compare)

1608 W FM
Big Spring, TX 79720-4113

1608 W FM 700
Big Spring, TX 79720-4113

500 W 4TH St
Odessa, TX 79761-5001
Phone (432) 640-4380

520 E 6TH St
Odessa, TX 79761-4527
Phone (432) 582-8535

601 Adams Ave
Odessa, TX 79761-4632
Phone (432) 337-2714

605 E 4TH St
Odessa, TX 79761-5100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting12
Pacemaker insertion or repair1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Big Bend Medical Group CurrentSince Oct 16, 2024 Accepting new patients
Big Bend Medical Group CurrentSince Oct 16, 2024 Accepting new patients
West Texas Diabetes and Endocrine Center PA Cardiovascular Disease Current Accepting new patients
Ector County Hospital District Past Accepting new patients
MCH Professional Care Cardiovascular Disease PastSince May 1, 2013 Accepting new patients

Locations

1608 W FM 700
Ste C
Big Spring, TX 79720
Phone (432) 263-7700

318 N Alleghaney Ave
Ste 201
Odessa, TX 79761
Phone (432) 332-1144

420 E 6th St
Ste 206
Odessa, TX 79761
Phone (432) 582-8480

500 W 4th St
Odessa, TX 79761
Phone (432) 640-1000

601 Adams Ave
Odessa, TX 79761
Phone (432) 337-2714

605 E 4th St
Ste 300
Odessa, TX 79761
Phone (432) 337-4347

605 E 4th St
Ste 320
Odessa, TX 79761
Phone (915) 337-2714

7101 Eastridge Rd
Odessa, TX 79765
Phone (432) 550-0048

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10465/brand/1/csg/1/fhir/r4

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 7

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": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700915303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 N ALLEGHANEY AVE",
            "address_2": "SUITE 402",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615052",
            "telephone_number": "432-337-2714",
            "fax_number": "432-337-2726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 N ALLEGHANEY AVE",
            "address_2": "SUITE 402",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615052",
            "telephone_number": "432-337-2714",
            "fax_number": "432-337-2726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUSALA",
        "first_name": "MADHAVA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "J1178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.