Individual provider Active NPI

Preetha Kandaswamy, MD

  • Pediatrics Physician
  • Plano, TX
National Provider Identifier
1740787043
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
T0823 Issued in TX
Practice address
6130 W Parker Rd Ste 410
Plano, TX 75093-7982
Phone
(469) 303-8380
Fax
(469) 303-0673
NPI assigned
Apr 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X T0823 TX Primary

Addresses

Primary practice location

6130 W Parker Rd Ste 410
Plano, TX 75093-7982

Mailing address

6130 W Parker Rd Ste 410
Plano, TX 75093-7982
Phone (469) 303-8380

Other identifiers 1

IdentifierTypeStateIssuer
T0823OtherTXLICENSE NUMBER

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210914000134 TX Practitioner - Pediatric Medicine 7012266364 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Physician Medical Services for Children Inc Pediatrics CurrentSince Aug 1, 2021 Accepting new patients
Dallas Physician Medical Services for Children Inc Pediatrics CurrentSince Aug 1, 2021 Accepting new patients

Locations

1935 Medical District Dr
Dallas, TX 75235
Phone (214) 456-2735

6130 W Park Blvd
Ste 410
Plano, TX 75093

6130 W Parker Rd
Ste 410
Plano, TX 75093
Phone (972) 981-8380

7601 Preston Rd
Plano, TX 75024
Phone (469) 303-7300

Interoperability endpoints

  • Direct secure messaging: pkandaswamy361646@direct.childrens.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1740787043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6130 W PARKER RD STE 410",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750937982",
            "telephone_number": "469-303-8380",
            "fax_number": "469-303-0673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6130 W PARKER RD STE 410",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750937982",
            "telephone_number": "469-303-8380",
            "fax_number": "469-303-0673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANDASWAMY",
        "first_name": "PREETHA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-12",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "T0823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "T0823",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.