NPIMap

Individual provider Active NPI

Jaya Krishnamoorthy, MD

  • Internal Medicine Physician
  • Arlington, TX
National Provider Identifier
1750566394
Registry record updated Apr 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
N0373 Issued in TX
Practice address
1050 W Arkansas LN
Arlington, TX 76013-6308
Phone
(817) 702-1100
Fax
(817) 702-4801
NPI assigned
Jan 2, 2008
Last updated
Apr 13, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036119470 IL
Internal Medicine Physician 207R00000X N0373 TX Primary

Addresses

Primary practice location

1050 W Arkansas LN
Arlington, TX 76013-6308

Mailing address

1412 May St
Fort Worth, TX 76104-7639
Phone (817) 702-2450

Other identifiers 5

IdentifierTypeStateIssuer
194635203MedicaidTX
P00919161OtherTXRAILROAD MEDICARE
8BQ002OtherTXBCBS
8EB685OtherTXBCBS
194635201MedicaidTX

Other names 1

  • Jayasankari Ponnusamy Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20080808000146 TX Practitioner - Internal Medicine 2466526470 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dallas County Hospital DistrictGroup PAC ID 8325934813, 597 clinicians

Practice addresses (Care Compare)

4600 Scyene Rd
Dallas, TX 75210-2219
Phone (214) 266-1200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.1 of 100Reported as group
Quality
88.97
Promoting interoperability
79
Improvement activities
40
Cost
83.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036119470ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas County Hospital District CurrentSince Aug 12, 2020 Accepting new patients
Dallas County Hospital District Internal Medicine CurrentSince Aug 12, 2020 Accepting new patients
Acclaim Physician Group, Inc Internal Medicine CurrentSince May 1, 2016 Accepting new patients
Dallas County Hospital District Current Accepting new patients

Locations

1050 W Arkansas Ln
Arlington, TX 76013
Phone (817) 277-6555

1350 S Main St
Fl 1
Fort Worth, TX 76104
Phone (817) 702-3701

1800 N Britain Rd
Irving, TX 75061
Phone (214) 266-3000

Interoperability endpoints

  • Direct secure messaging: jkrishnamoorthy112247@direct.phhs.org
  • Direct secure messaging: jkrishnamoorthy23332@direct.jpshealth.org

Organizations & group practices 4

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 44

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

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523577600000",
    "number": "1750566394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 MAY ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761047639",
            "telephone_number": "817-702-2450",
            "fax_number": "817-702-8445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 W ARKANSAS LN",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760136308",
            "telephone_number": "817-702-1100",
            "fax_number": "817-702-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISHNAMOORTHY",
        "first_name": "JAYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-02",
        "last_updated": "2018-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036119470",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N0373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "194635203",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00919161",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8BQ002",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8EB685",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "194635201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAYASANKARI",
            "last_name": "PONNUSAMY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Arlington, TX

Sources for this page

Verify at the official NPI Registry.