Individual provider Active NPI

Kumud S Tripathy, M.D.

  • Medical Oncology Physician
  • Bryan, TX
National Provider Identifier
1811949407
Registry record updated Sep 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
F9046 Issued in TX
Practice address
2215 E Villa Maria Rd
#110
Bryan, TX 77802-2548
Phone
(979) 776-2000
Fax
(979) 776-0427
NPI assigned
May 16, 2006
Last updated
Sep 20, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X F9046 TX Primary

Addresses

Primary practice location

2215 E Villa Maria Rd
#110
Bryan, TX 77802-2548

Mailing address

2215 E Villa Maria Rd
#110
Bryan, TX 77802-2548
Phone (979) 776-2000

Other identifiers 3

IdentifierTypeStateIssuer
125738100OtherTXFIRST CARE
110135938OtherTXMEDICARE RAILROAD
100005101MedicaidTX

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
I20101213000728 TX Practitioner - Hematology/Oncology 1759389968 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brazos Valley Hematology Oncology Associates, PA CurrentSince Mar 3, 1982 Accepting new patients
Brazos Valley Hematology Oncology Associates, PA CurrentSince Mar 3, 1982 Accepting new patients
St Joseph Regional Health Center PastSince Feb 1, 1999 Accepting new patients

Locations

2215 E Villa Maria Rd
Ste 110
Bryan, TX 77802
Phone (979) 776-2000

2435 Harvey Mitchell Pkwy S
College Station, TX 77845
Phone (979) 776-2000

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190246400000",
    "number": "1811949407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 E VILLA MARIA RD",
            "address_2": "#110",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022548",
            "telephone_number": "979-776-2000",
            "fax_number": "979-776-0427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 E VILLA MARIA RD",
            "address_2": "#110",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022548",
            "telephone_number": "979-776-2000",
            "fax_number": "979-776-0427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIPATHY",
        "first_name": "KUMUD",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2007-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "TX",
            "license": "F9046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST CARE",
            "identifier": "125738100",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "110135938",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100005101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

Verify at the official NPI Registry.