Bhavani Choudary Suryadevara, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

S8392 Issued in TX

Practice address

1000 S Beckham Ave
Tyler, TX 75701-1908

Phone

(903) 590-5611

Fax

(903) 535-6884

NPI assigned

Sep 28, 2009

Last updated

Feb 22, 2021By 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 identifiers 1

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

Internal Medicine

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ut Health East Texas Tyler Regional Hospital Hospital, Tyler, TX, CCN 450083
• University of Texas Health Science Center at Tyler Hospital, Tyler, TX, CCN 450690
• Ut Health East Texas Athens Hospital Hospital, Athens, TX, CCN 450389

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bsuryadevara355068@ahs.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.

• Etmc Physician Group Inc.

  • Cardiovascular Disease Physician
  • Tyler, TX
  • NPI 1609382662
  Medicare reassignment Care Compare group NPD
• University of Texas Health Science Center at Tyler-Facility-Physician

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Tyler, TX
  • NPI 1063400778
  Medicare reassignment NPD
• Etmc Physician Group Inc.

  • Rural Health Clinic/Center
  • Chandler, TX
  • NPI 1235706581
  NPD
• University of Texas Health Science Center at Tyler-Facilty-Physician

  dba UT Health East Texas Physicians Overton

  • Rural Health Clinic/Center
  • Overton, TX
  • NPI 1689496812
  NPD
• Starks Medical

  • Primary Care Nurse Practitioner
  • Bullard, TX
  • NPI 1306570593
  NPD (past)
• Tyler Family Circle of Care

  dba Family Circle of Care

  • Community/Retail Pharmacy
  • Tyler, TX
  • NPI 1942011903
  NPD (past)
• Tyler Regional Hospital LLC

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1407364847
  NPD (past)
• Inpatient Consultants of Colorado, PC

  • Internal Medicine Physician
  • Denver, CO
  • NPI 1538461256
  NPD (past)

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

• Athens Hospital, LLC

  • General Acute Care Hospital
  • Athens, TX
  • NPI 1417465824
  Care Compare affiliation
• Tyler Regional Hospital LLC

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1407364847
  Care Compare affiliation
• University of Texas Health Science Center at Tyler

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1417941295
  Care Compare affiliation

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

{
    "created_epoch": "1254096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1710211578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130549",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757130549",
            "telephone_number": "903-579-3931",
            "fax_number": "903-509-5835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S BECKHAM AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011908",
            "telephone_number": "903-590-5611",
            "fax_number": "903-535-6884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURYADEVARA",
        "first_name": "BHAVANI",
        "middle_name": "CHOUDARY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-28",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "52980",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "S8392",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CO",
            "license": "52980",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "57137285",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zahide Sunal, PH.D.,LPC, NCC
• Tammie Sunderman
• Sunlite Healthcare Services , Inc .
• Surgical Assisting of East Texas, LLC
• Surgical Associates of East Texas, LLP
• Kathryn Sustaita
• Sheryl Sutfin, FNP-BC
• Angela Sutherland
• Judith Denise Sutherland, LCSW
• Elizabeth Whitney Sutliff, MD

• Internal Medicine Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2021; 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.