NPIMap

Individual provider Active NPI

Tejaswi Bhari Thippeswamy, MD,

  • Family Medicine Physician
  • Coffeyville, KS
National Provider Identifier
1811189269
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0442440 Issued in KS
Practice address
1400 W 4TH
Coffeyville, KS 67337-3306
Phone
(209) 383-7441
NPI assigned
Aug 9, 2007
Last updated
Jan 23, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25886 OK
Family Medicine Physician 207Q00000X E6737 AR
Family Medicine Physician 207Q00000X A132344 CA
Family Medicine Physician 207Q00000X 0442440 KS Primary

Addresses

Primary practice location

1400 W 4TH
Coffeyville, KS 67337-3306

Mailing address

1910 Customer Care Way
Atwater, CA 95301-5167
Phone (209) 384-6488

Other identifiers 4

IdentifierTypeStateIssuer
189923001MedicaidAR
5H894OtherARBCBS
E6737OtherARSTATE LICENSE
9186194726OtherOKUNIVERSITY OF OKLAHOMA

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
I20130624000298 TX Practitioner - Family Practice 1456521509 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MMH PhysiciansGroup PAC ID 1759675911, 29 clinicians
MCH Professional Care Hospital BasedGroup PAC ID 1557535127, 81 clinicians

Practice addresses (Care Compare)

400 Rosalind Redfern Grover Pkwy
Midland, TX 79701-5846
Phone (432) 221-1111

500 W 4TH St
Odessa, TX 79761-5001
Phone (432) 640-2401

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.41 of 100Reported as group
Quality
72.52
Improvement activities
40
Cost
81.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E6737ARMDFamily Medicine Physician
A132344CAMDFamily Medicine Physician
0442440KSMDFamily Medicine Physician
25886OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Choctaw Nation of Oklahoma CurrentSince May 13, 2013 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince May 13, 2013 Accepting new patients
MCH Professional Care Hospital Based Family Medicine CurrentSince May 1, 2022 Accepting new patients
Choctaw Nation of Oklahoma Current Accepting new patients
Usacs Integrated Acute Care Services of Texas, PLLC CurrentSince Jan 14, 2025 Accepting new patients
MMH Physicians CurrentSince Aug 1, 2025 Accepting new patients
Ector County Hospital District Past Accepting new patients

Locations

410 N M St
Hugo, OK 74743
Phone (580) 326-7561

1 Choctaw Way
Talihina, OK 74571
Phone (918) 423-8440

3501 Mills Ave
Austin, TX 78731
Phone (512) 324-1017

260 Cully Dr
Kerrville, TX 78028
Phone (830) 258-7323

400 Rosalind Redfern Grover Pkwy
Midland, TX 79701
Phone (432) 221-4850

400 Rosalind Redfern Grover Pkwy
Ste 100
Midland, TX 79701
Phone (432) 687-1949

500 W 4th St
Odessa, TX 79761
Phone (432) 640-1000

6565 Fannin St
Va Hospital, TX 77030
Phone (713) 394-6000

Interoperability endpoints

  • Direct secure messaging: tthippeswamy510259@christushealth.direct-ci.net

Organizations & group practices 7

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 7

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": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1811189269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 CUSTOMER CARE WAY",
            "city": "ATWATER",
            "state": "CA",
            "postal_code": "953015167",
            "telephone_number": "209-384-6488",
            "fax_number": "855-202-9336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 W 4TH",
            "city": "COFFEYVILLE",
            "state": "KS",
            "postal_code": "673373306",
            "telephone_number": "209-383-7441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIPPESWAMY",
        "first_name": "TEJASWI",
        "middle_name": "BHARI",
        "name_prefix": "Dr.",
        "credential": "MD,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-09",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "25886",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E6737",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A132344",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "0442440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "189923001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5H894",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "E6737",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERSITY OF OKLAHOMA",
            "identifier": "9186194726",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coffeyville, KS

Sources for this page

Verify at the official NPI Registry.