Individual provider Active NPI

Eswara Kumar Mundra, MD

  • Radiation Oncology Physician
  • Jackson, MS
National Provider Identifier
1710362025
Registry record updated Jan 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
947-L Issued in MS
Practice address
2500 North State Street
University of Mississippi Medical Center Radiation Onco
Jackson, MS 39216-4505
Phone
(601) 815-6886
Fax
(601) 815-6876
NPI assigned
Jul 28, 2015
Last updated
Jan 29, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 947-L MS
Radiation Oncology Physician 2085R0001X 947-L MS Primary

Addresses

Primary practice location

2500 North State Street
University of Mississippi Medical Center Radiation Onco
Jackson, MS 39216-4505

Mailing address

2500 North State Street
University of Mississippi Medical Center
Jackson, MS 39216-4505
Phone (601) 815-6886

Other identifiers 1

IdentifierTypeStateIssuer
07083393MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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

Enrollment IDStateProvider typePAC IDDetails
I20190129003423 MS Practitioner - Radiation Oncology 6507173721 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2500 N State St
Jackson, MS 39216-4500
Phone (601) 898-4404

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.94 of 100Reported as group
Quality
67.75
Promoting interoperability
100
Improvement activities
40
Cost
71.17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
947-LMSMDGeneral Acute Care Hospital

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center General Acute Care Hospital CurrentSince Oct 3, 2018 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Oct 3, 2018 Accepting new patients
University Physicians, PLLC Past Accepting new patients

Locations

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

350 W Woodrow Wilson Ave
Ste 600
Jackson, MS 39213
Phone (601) 815-6700

Interoperability endpoints

  • Direct secure messaging: emundra56783@ummc.direct-ci.com

Organizations & group practices 3

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 1

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": "1438041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548720000000",
    "number": "1710362025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NORTH STATE STREET",
            "address_2": "UNIVERSITY OF MISSISSIPPI MEDICAL CENTER",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164505",
            "telephone_number": "601-815-6886",
            "fax_number": "601-815-6876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NORTH STATE STREET",
            "address_2": "UNIVERSITY OF MISSISSIPPI MEDICAL CENTER RADIATION ONCO",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164505",
            "telephone_number": "601-815-6886",
            "fax_number": "601-815-6876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNDRA",
        "first_name": "ESWARA",
        "middle_name": "KUMAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-28",
        "last_updated": "2019-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MS",
            "license": "947-L",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MS",
            "license": "947-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07083393",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.