Individual provider Active NPI

Sripathi R Kethu, M.D.

  • Gastroenterology Physician
  • Richardson, TX
National Provider Identifier
1801840111
Registry record updated Sep 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
M6699 Issued in TX
Practice address
2821 E President George Bush Hwy
Suite 205
Richardson, TX 75082-4266
Phone
(972) 238-9696
Fax
(972) 238-9753
NPI assigned
May 20, 2006
Last updated
Sep 23, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2020

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 M6699 TX Primary

Addresses

Primary practice location

2821 E President George Bush Hwy
Suite 205
Richardson, TX 75082-4266

Mailing address

7610 N Stemmons Fwy Ste 600
Dallas, TX 75247-4228
Phone (214) 689-5960

Other identifiers 2

IdentifierTypeStateIssuer
8A7898OtherTXBCBSTX
186440701MedicaidTX

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
I20070801000763 TX Practitioner - GastroenterologyPractitioner - Internal Medicine 2365355526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2821 E President George Bush Hwy
Suite 205
Richardson, TX 75082-4277
Phone (972) 238-9696

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
Colonoscopy112
Upper gastrointestinal (GI) endoscopy for acid reflux137

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M6699TXMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Digestive Disease Consultants, PLLC Gastroenterology CurrentSince Jul 1, 2021 Accepting new patients
Texas Digestive Disease Consultants, PLLC Gastroenterology Current Accepting new patients
Integrated Physical Therapy Current Accepting new patients
Texas Digestive Disease Consultants PLLC Gastroenterology CurrentSince Jul 1, 2021 Accepting new patients
North Texas Physician Associates, PLLC PastSince Apr 30, 2003 Accepting new patients
University Medicine Foundation, Inc. PastSince Jan 1, 1990 Accepting new patients

Locations

5425 W Spring Creek Pkwy
Ste 205
Plano, TX 75024
Phone (972) 526-5860

2821 George Bush Hwy
Ste 205
Richardson, TX 75082
Phone (972) 238-9696

7501 Lakeview Pkwy
Ste 260
Rowlett, TX 75088
Phone (972) 475-8183

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

Hospital & facility affiliations 1

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1801840111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7610 N STEMMONS FWY STE 600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474228",
            "telephone_number": "214-689-5960",
            "fax_number": "469-713-8084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 E PRESIDENT GEORGE BUSH HWY",
            "address_2": "SUITE 205",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750824266",
            "telephone_number": "972-238-9696",
            "fax_number": "972-238-9753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETHU",
        "first_name": "SRIPATHI",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "M6699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "8A7898",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "186440701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

Verify at the official NPI Registry.