Active NPI
Nagapavani Kandagari
- Family Medicine Physician
- Las Cruces, NM
National Provider Identifier
1750906285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- RS2020-0540
- Practice address
- 2450 S Telshor Blvd
Las Cruces, NM 88011-5069 - Phone
- (575) 521-5385
- NPI assigned
- Jun 10, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | RS2020-0540 | NM | Primary |
Addresses
Primary practice location
2450 S Telshor Blvd
Las Cruces, NM 88011-5069
Mailing address
2450 S Telshor Blvd
Las Cruces, NM 88011-5069
Phone (575) 521-5385
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2017
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1400 SW 5TH Ave
FL 5
Portland, OR 97201-5509
2988 Maddox LP
Las Cruces, NM 88011
Hospital & facility affiliations
- Ohsu Hospital and Clinics
- Hillsboro Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RS2020-0540 | NM | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Professional Services | Current | Accepting new patients | |
| University Professional Services | Current | Accepting new patients | |
| Tuality Medical Group LLC | Current | Accepting new patients | |
| Tuality Medical Group LLC | Current | Accepting new patients |
Locations
15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000
335 SE 8th Ave
Hillsboro, OR 97123
Phone (503) 681-1111
3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674
Interoperability endpoints
- nagapavani.kandagari.1@19849.direct.athenahealth.com
- nkandagari167262@direct.ohsu.edu
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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Hillsboro, OR
- NPI 1073929782
-
- General Practice Physician
- Portland, OR
- NPI 1376709535
-
- Neurology Physician
- Hillsboro, OR
- NPI 1639690704
-
- Pharmacy
- Beaverton, OR
- NPI 1073054714
Hospital & facility affiliations 13
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Portland, OR
- NPI 1609824010
-
- Psychiatric Hospital
- Hillsboro, OR
- NPI 1073817714
-
- General Acute Care Hospital
- Hillsboro, OR
- NPI 1275591984
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591747200000",
"number": "1750906285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2450 S TELSHOR BLVD",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880115069",
"telephone_number": "575-521-5385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2450 S TELSHOR BLVD",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880115069",
"telephone_number": "575-521-5385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANDAGARI",
"first_name": "NAGAPAVANI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-10",
"last_updated": "2020-06-10",
"certification_date": "2020-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NM",
"license": "RS2020-0540",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Cruces, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.