NPIMap

Individual provider Active NPI

Sreedevi Gangireddy, MD

  • Internal Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1780657858
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
Q1607 Issued in TX
Practice address
1300 W Terrell Ave Ste K230
Fort Worth, TX 76104-2820
Phone
(817) 250-4906
Fax
(817) 250-1815
NPI assigned
Feb 9, 2006
Last updated
Mar 31, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 49980 WI
Internal Medicine Physician 207R00000X Q1607 TX Primary

Addresses

Primary practice location

1300 W Terrell Ave Ste K230
Fort Worth, TX 76104-2820

Mailing address

1300 W Terrell Ave Ste K230
Fort Worth, TX 76104-2820
Phone (817) 250-4906

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sgangireddy262421@direct.sw.org

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
I20150213001717 TX Practitioner - Internal Medicine 0345272217 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

1400 8TH Ave
Fort Worth, TX 76104-4110

1650 W College St
Grapevine, TX 76051-3565
Phone (817) 388-3440

4001 Worth St
Dallas, TX 75246-1608

5408 Colleyville Blvd
Colleyville, TX 76034-5833
Phone (817) 498-9920

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Jan 23, 2017 Accepting new patients
Healthtexas Provider Network Internal Medicine CurrentSince Jan 23, 2017 Accepting new patients
Healthtexas Provider Network Internal Medicine Current Accepting new patients
Healthtexas Provider Network Past Accepting new patients
Baylor Regional Medical Center at Grapevine Past Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

1650 W College St
Ste 150
Grapevine, TX 76051
Phone (817) 344-3880

Interoperability endpoints

  • Direct secure messaging: sgangireddy262421@direct.sw.org

Organizations & group practices 5

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 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": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1780657858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W TERRELL AVE STE K230",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042820",
            "telephone_number": "817-250-4906",
            "fax_number": "817-250-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W TERRELL AVE STE K230",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042820",
            "telephone_number": "817-250-4906",
            "fax_number": "817-250-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANGIREDDY",
        "first_name": "SREEDEVI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WI",
            "license": "49980",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "Q1607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sgangireddy262421@direct.sw.org",
            "affiliation": "N",
            "address_1": "1650 W College St Ste 150",
            "city": "Grapevine",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760513565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.