Individual provider Active NPI

Kiran Mendha, M.D.

  • Adult Medicine Physician
  • Frisco, TX
National Provider Identifier
1790210912
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
S8881 Issued in TX
Practice address
5550 Warren Pkwy Ste 120
Frisco, TX 75034-7399
Phone
(469) 905-3780
NPI assigned
Apr 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X S8881 TX Primary
Family Medicine Physician 207Q00000X S8881 TX

Addresses

Primary practice location

5550 Warren Pkwy Ste 120
Frisco, TX 75034-7399

Mailing address

5550 Warren Pkwy Ste 120
Frisco, TX 75034-7399

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
I20210719000014 TX Practitioner - Family Practice 4587935382 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mendha Primary Care PLLCGroup PAC ID 9830565985, 3 clinicians

Practice addresses (Care Compare)

5550 Warren Pkwy
Suite 120
Frisco, TX 75034-7329
Phone (469) 905-3780

850 S Sherman St
Richardson, TX 75081-4030
Phone (469) 905-3780

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S8881TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
A2Z Med Group PLLC Family Medicine CurrentSince Oct 24, 2024 Accepting new patients
Mendha Primary Care PLLC Family Medicine CurrentSince Oct 17, 2022 Accepting new patients
Mendha Primary Care PLLC Adult Medicine CurrentSince Oct 24, 2024 Accepting new patients

Locations

5550 Warren Pkwy
Ste 120
Frisco, TX 75034
Phone (469) 905-3780

850 S Sherman St
Richardson, TX 75081
Phone (469) 905-3780

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1493078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1790210912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5550 WARREN PKWY STE 120",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750347399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5550 WARREN PKWY STE 120",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750347399",
            "telephone_number": "469-905-3780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDHA",
        "first_name": "KIRAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-25",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "TX",
            "license": "S8881",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "S8881",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

Verify at the official NPI Registry.