Beulah Jyothy Koduru, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD2020-0643 Issued in NM

Practice address

1 University of New Mexico Hospital MSC 10 5550
Albuquerque, NM 87131-5640

Phone

(505) 272-2111

NPI assigned

Jul 16, 2016

Last updated

Jul 29, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

Internal Medicine

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Houston County Healthcare AuthorityGroup PAC ID 9436062296, 256 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southeast Health Medical Center Hospital, Dothan, AL, CCN 010001
• Jackson Hospital Hospital, Marianna, FL, CCN 100142

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Houston County Healthcare Authority

  dba Samc-Enterprise Medical Clinic

  • Internal Medicine Physician
  • Enterprise, AL
  • NPI 1619026606
  Medicare reassignment Care Compare group NPD
• Houston County Healthcare Authority

  dba Southeast Alabama Medical Center Medical Clinics

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1538597349
  NPD
• Houston County Healthcare Authority

  dba Southeast Alabama Medical Center

  • General Acute Care Hospital
  • Dothan, AL
  • NPI 1164403861
  NPD (past)

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

• Houston County Healthcare Authority

  dba Southeast Alabama Medical Center

  • General Acute Care Hospital
  • Dothan, AL
  • NPI 1164403861
  Care Compare affiliation
• Jackson County Hospital District

  • General Acute Care Hospital
  • Marianna, FL
  • NPI 1538108725
  Care Compare affiliation

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

{
    "created_epoch": "1468627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1780037507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6301 ALAMEDA BLVD NE UNIT 2007",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871132587",
            "telephone_number": "312-909-7318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 UNIVERSITY OF NEW MEXICO HOSPITAL MSC 10 5550",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871315640",
            "telephone_number": "505-272-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KODURU",
        "first_name": "BEULAH JYOTHY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-16",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.068685",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "MD2020-0643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Kochersperger, CPSW
• Brianna Nicole Kocurek
• Tamara Kodis, MD
• Elizabeth Louise Kodituwakku, PHD - PSYCHOLOGIST
• Piyadasa Kodituwakku, PHD
• Rodgers Koech, ARNP
• Koehler Physiatry LLC
• Jonathan Koehler
• Terry Smith Koehler, LPCC
• Alexandra Lee Koenig, PHD

• Internal Medicine Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Internal Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.

Verify at the official NPI Registry.