NPIMap

Individual provider Active NPI

Kishore Patcha, M.D.

  • Nephrology Physician
  • Galveston, TX
National Provider Identifier
1710242946
Registry record updated Nov 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
10310641-1205 Issued in UT
Practice address
301 University Blvd
4.174 John Sealy Annex
Galveston, TX 77555-0566
Phone
(409) 772-7399
NPI assigned
Jul 13, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Q3571 TX
Internal Medicine Physician 207R00000X BP10043728 TX
Nephrology Physician 207RN0300X 10310641-1205 UT Primary

Addresses

Primary practice location

301 University Blvd
4.174 John Sealy Annex
Galveston, TX 77555-0566

Mailing address

30 N 1900 E RM 4R312
Salt Lake City, UT 84132-0002

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kpatcha286303@direct.med.utah.edu Direct UNIVERSITY OF UTAH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, WY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200402000300 UT Practitioner - Nephrology 0446561070 Reassigns benefits to 1 organization
I20200720001234 WY Practitioner - Nephrology 0446561070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Utah Adult ServicesGroup PAC ID 0941525273, shared by 7 NPIs, 1,758 clinicians

Practice addresses (Care Compare)

196 Arrowhead Dr
Suite 7
Evanston, WY 82930-8752
Phone (307) 444-8231

50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 585-3229

Hospital & facility affiliations

  • DaVita Mark Lindsay Dialysis Dialysis facility, Ogden, UT, CCN 462544
  • DaVita Farmington Bay Dialysis Center Dialysis facility, Layton, UT, CCN 462500
  • DaVita Bonneville Dialysis Center Dialysis facility, Ogden, UT, CCN 462519
  • Evanston Dialysis Center Dialysis facility, Evanston, WY, CCN 532307
  • Intermountain Health McKay-Dee Hospital Hospital, Ogden, UT, CCN 460004
  • University of Utah Hospital and Clinics Hospital, Salt Lake City, UT, CCN 460009
  • Evanston Regional Hospital Hospital, Evanston, WY, CCN 531319
  • Brigham City Community Hospital Hospital, Brigham City, UT, CCN 460017
  • Bear River Valley Hospital Hospital, Tremonton, UT, CCN 460039

Merit-based Incentive Payment System (MIPS)

Final score
89.77 of 100Reported as group
Quality
91.47
Promoting interoperability
100
Improvement activities
40
Cost
74.42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10043728TXMDInternal Medicine Physician
10310641-1205UTMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services Current Accepting new patients
University of Utah Adult Services Current Accepting new patients
University of Utah Adult Services CurrentSince Jun 15, 2020 Accepting new patients
University of Utah Adult Services CurrentSince Feb 17, 2020 Accepting new patients
Bronson Lakeview Hospital Internal Medicine PastSince Aug 1, 2022 Accepting new patients

Locations

127 S 500 E
Ste 400B
Salt Lake City, UT 84102
Phone (801) 587-6478

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

196 Arrowhead Dr
Ste 7
Evanston, WY 82930
Phone (307) 783-8364

1200 College Dr
Rock Springs, WY 82901
Phone (307) 352-8352

Interoperability endpoints

  • Direct secure messaging: kpatcha286303@direct.med.utah.edu
  • Direct secure messaging: kpatcha@yourcarecommunity.org

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 and National Provider Directory roles.

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": "1342137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1710242946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N 1900 E RM 4R312",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "address_2": "4.174 JOHN SEALY ANNEX",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775550566",
            "telephone_number": "409-772-7399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATCHA",
        "first_name": "KISHORE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-13",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "Q3571",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "BP10043728",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "UT",
            "license": "10310641-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpatcha286303@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "UNIVERSITY OF UTAH",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

Verify at the official NPI Registry.