NPIMap

Individual provider Active NPI

Krishna Kidambi

  • Internal Medicine Physician
  • San Angelo, TX
National Provider Identifier
1740785906
Registry record updated Feb 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
S4649 Issued in TX
Practice address
271 Fort Richardson Avenue
San Angelo, TX 76908
Phone
(654) 325-3117
NPI assigned
Mar 28, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X S4649 TX Primary
Emergency Medicine Physician 207P00000X 34.016747.MIL OH
Emergency Medicine Physician 207P00000X 21333 ND
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

271 Fort Richardson Avenue
San Angelo, TX 76908

Mailing address

1599 J St
Grand Forks, ND 58205-6306

Other practice location 1

3551 Roger Brooke Dr
San Antonio, TX 78234
Phone (813) 770-9826

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20241001003809 ND Practitioner - Emergency Medicine 9830529205 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
William Carey University College of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthsource Partners ND LLCGroup PAC ID 1052664091, 2 clinicians

Practice addresses (Care Compare)

900 E Broadway Ave
Bismarck, ND 58501-4520
Phone (701) 530-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21333NDMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthsource Partners ND LLC Emergency Medicine CurrentSince Feb 2, 2025 Accepting new patients
Mercy Hospital of Devils Lake CurrentSince Jul 19, 2024 Accepting new patients
Sanford Medical Center Fargo CurrentSince Mar 7, 2026 Accepting new patients
Mercy Hospital of Devils Lake Emergency Medicine Current Accepting new patients
Mercy Hospital of Devils Lake Current Accepting new patients
Sanford Medical Center Fargo CurrentSince Mar 7, 2026 Accepting new patients

Locations

3290 Solutions Ctr
Chicago, IL 60677

900 E Broadway Ave
Bismarck, ND 58501
Phone (701) 530-7300

1031 7th St NE
Devils Lake, ND 58301
Phone (701) 662-2131

Organizations & group practices 7

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": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771286400000",
    "number": "1740785906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1599 J ST",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582056306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 FORT RICHARDSON AVENUE",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "76908",
            "telephone_number": "654-325-3117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3551 Roger Brooke Dr",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "78234",
            "country_code": "US",
            "telephone_number": "813-770-9826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIDAMBI",
        "first_name": "KRISHNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-28",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "S4649",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34.016747.MIL",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ND",
            "license": "21333",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

Verify at the official NPI Registry.