NPIMap

Individual provider Active NPI

Subba Raju Kosuri, MD

  • Internal Medicine Physician
  • Dallas, TX
National Provider Identifier
1851339493
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
K6061 Issued in TX
Practice address
9 Medical Pkwy
Plaza 4, Suite 207
Dallas, TX 75234-7858
Phone
(972) 488-9656
Fax
(972) 488-9636
NPI assigned
Jun 4, 2006
Last updated
Jul 28, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X K6061 TX Primary
Cardiovascular Disease Physician 207RC0000X K6061 TX

Addresses

Primary practice location

9 Medical Pkwy
Plaza 4, Suite 207
Dallas, TX 75234-7858

Mailing address

9 Medical Pkwy
Plaza 4, Suite 207
Dallas, TX 75234-7858
Phone (972) 488-9656

Other identifiers 1

IdentifierTypeStateIssuer
044799706MedicaidTX

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
I20050822000467 TX Practitioner - Cardiovascular Disease (Cardiology) 1557325297 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9 Medical Pkwy
Dallas, TX 75234-7858
Phone (931) 548-4646

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K6061TXMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Medical Physician Group Internal Medicine CurrentSince Aug 17, 2013 Accepting new patients
Texas Heart Care Cardiovascular Disease Current Accepting new patients
LHP Texas MD Services Inc CurrentSince May 3, 2022 Accepting new patients
Dallas Medical Physician Group Internal Medicine CurrentSince Aug 17, 2013 Accepting new patients
Columbia North Hills Hospital Subsidiary LP Past Accepting new patients
Physicians and Allied Health Professionals Group, PA Internal Medicine Past Accepting new patients
Dallas Medical Center LLC PastSince Mar 21, 2010 Accepting new patients

Locations

1 Medical Pkwy
Ste 103
Dallas, TX 75234
Phone (972) 488-9656

9 Medical Pkwy
Ste 207
Dallas, TX 75234
Phone (972) 488-6666

800 W Central Texas Expy
Harker Heights, TX 76548
Phone (254) 618-4933

5308 N Galloway Ave
Mesquite, TX 75150
Phone (972) 226-0505

Interoperability endpoints

  • Direct secure messaging: dmcskosur@yourcarecommunity.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/DDHACD/Endpoint/DDHACD
  • Direct secure messaging: skosuri287707@ahs.direct-ci.com

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Baylor Scott & White the Heart Hospital - PlanoPlano, TX, CCN 670025 Hospital General Partnership Interest Jul 1, 2005
Baylor Scott & White the Heart Hospital - DentonDenton, TX, CCN 450893 Hospital General Partnership Interest Jul 1, 2005
Baylor Scott & White the Heart Hospital RehabilitationDenton, TX, CCN 67T347 Hospital General Partnership Interest Nov 1, 2024
Baylor Scott & White the Heart Hospital - CorinthDenton, TX, CCN 670347 Hospital General Partnership Interest Nov 1, 2024

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 8

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": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1851339493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 MEDICAL PKWY",
            "address_2": "PLAZA 4, SUITE 207",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752347858",
            "telephone_number": "972-488-9656",
            "fax_number": "972-488-9636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 MEDICAL PKWY",
            "address_2": "PLAZA 4, SUITE 207",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752347858",
            "telephone_number": "972-488-9656",
            "fax_number": "972-488-9636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSURI",
        "first_name": "SUBBA RAJU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K6061",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "K6061",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044799706",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.