Individual provider Active NPI

Mridula Nadamuni

  • Hematology & Oncology Physician
  • Houston, TX
National Provider Identifier
1770015604
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
S1872 Issued in TX
Practice address
1400 Holcombe Blvd Unit 463
Houston, TX 77030-4008
Phone
(713) 745-1827
NPI assigned
Mar 30, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 292884 MA
Internal Medicine Physician 207R00000X S1872 TX
Pediatrics Physician 208000000X S1872 TX
Hospitalist Physician 208M00000X 75477 CT
Student in an Organized Health Care Education/Training Program 390200000X
Hematology & Oncology Physician 207RH0003X S1872 TX Primary

Addresses

Primary practice location

1400 Holcombe Blvd Unit 463
Houston, TX 77030-4008

Mailing address

1400 Holcombe Blvd Unit 463
Houston, TX 77030-4008

Other practice location 1

75 Francis St
Boston, MA 02115-6106
Phone (617) 732-5500

Other practice location 2

20 York Street, CB-2041
New Haven, CT 06510-3220
Phone (203) 688-4748

Other practice location 3

5200 Harry Hines Blvd
Dallas, TX 75235-7709
Phone (214) 590-4656

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210503001705 TX Practitioner - Internal Medicine 3577972645 Reassigns benefits to 1 organization
I20221128002200 MA Practitioner - Internal Medicine 3577972645 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
292884MAMDInternal Medicine Physician
S1872TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Physicians Organization Inc Internal Medicine CurrentSince Nov 1, 2022 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
Brigham & Womens Hospital, Inc. CurrentSince Nov 1, 2022 Accepting new patients
Northeast Medical Group, Inc. Internal Medicine CurrentSince Jul 21, 2023 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jun 16, 2021 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Internal Medicine CurrentSince Jun 16, 2021 Accepting new patients

Locations

20 York St
Unit CB2041
New Haven, CT 06510
Phone (203) 688-4741

1450 Chapel St
New Haven, CT 06511
Phone (203) 789-3151

20 York St
#2041
North Haven, CT 06510
Phone (203) 688-1734

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

75 Francis St
Boston, MA 02115

1153 Centre St
Jamaica Plain, MA 02130
Phone (617) 983-7000

254 2nd Ave
Ste 100
Needham Heights, MA 02494
Phone (781) 416-8412

399 Revolution Dr
Somerville, MA 02145
Phone (800) 856-1983

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

6201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 633-4700

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Interoperability endpoints

  • Direct secure messaging: mnadamuni71774@direct.phhs.org

Organizations & group practices 6

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": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1770015604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 HOLCOMBE BLVD UNIT 463",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 HOLCOMBE BLVD UNIT 463",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304008",
            "telephone_number": "713-745-1827"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Francis St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021156106",
            "country_code": "US",
            "telephone_number": "617-732-5500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20 York Street, CB-2041",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065103220",
            "country_code": "US",
            "telephone_number": "203-688-4748",
            "fax_number": "203-688-4740",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5200 Harry Hines Blvd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752357709",
            "country_code": "US",
            "telephone_number": "214-590-4656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NADAMUNI",
        "first_name": "MRIDULA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-30",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "292884",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "S1872",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "S1872",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CT",
            "license": "75477",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "TX",
            "license": "S1872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.