Individual provider Active NPI

Muralidhar Pathikonda, M.D.

  • Gastroenterology Physician
  • Fort Worth, TX
National Provider Identifier
1760677769
Registry record updated Apr 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
P9689 Issued in TX
Practice address
900 W Magnolia Ave Ste 100
Fort Worth, TX 76104-8518
Phone
(817) 870-7300
Fax
(817) 332-5117
NPI assigned
Sep 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X P9689 TX Primary

Addresses

Primary practice location

900 W Magnolia Ave Ste 100
Fort Worth, TX 76104-8518

Mailing address

PO Box 35629
Dallas, TX 75235-0629
Phone (214) 424-2200

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
I20141111000324 TX Practitioner - Gastroenterology 3274755038 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

505 S Nolen Dr
A
Southlake, TX 76092-9167
Phone (817) 424-1525

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.98 of 100Reported as group
Quality
66.51
Promoting interoperability
98
Improvement activities
40
Cost
71.76

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy70
Upper gastrointestinal (GI) endoscopy for acid reflux93

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Digestive Disease Consultants PLLC Gastroenterology CurrentSince Dec 1, 2017 Accepting new patients
Texas Digestive Disease Consultants, PLLC Gastroenterology Current Accepting new patients
Texas Digestive Disease Consultants, PLLC Gastroenterology CurrentSince Dec 1, 2017 Accepting new patients

Locations

900 W Magnolia Ave
Ste 100
Ft Worth, TX 76104
Phone (817) 870-7300

601 S Main St
Keller, TX 76248
Phone (817) 741-4347

505 S Nolen Dr
#A
Southlake, TX 76092
Phone (817) 424-1525

750 Eureka St
Ste B
Weatherford, TX 76086
Phone (817) 599-6222

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556236800000",
    "number": "1760677769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35629",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752350629",
            "telephone_number": "214-424-2200",
            "fax_number": "214-231-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W MAGNOLIA AVE STE 100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761048518",
            "telephone_number": "817-870-7300",
            "fax_number": "817-332-5117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATHIKONDA",
        "first_name": "MURALIDHAR",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-12",
        "last_updated": "2019-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "P9689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.