Individual provider Active NPI

Sowjanya Kanna, MD

  • Gastroenterology Physician
  • Tarentum, PA
National Provider Identifier
1851624787
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD462002 Issued in PA
Practice address
301 E 1St Ave
Tarentum, PA 15084-1858
Phone
(724) 224-3113
Fax
(724) 224-2447
NPI assigned
Sep 10, 2009
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 MD462002 PA Primary

Addresses

Primary practice location

301 E 1St Ave
Tarentum, PA 15084-1858

Mailing address

301 E 1St Ave
Tarentum, PA 15084-1858
Phone (724) 224-3113

Other identifiers 2

IdentifierTypeStateIssuer
103351129MedicaidPA
14098931OtherCAQH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address skanna142892@direct.ahn.org

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
I20230327001603 TX Practitioner - Internal Medicine 6709020290 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

111 S Preston Rd
10 Baylor Scott and White Primary Care Prospe
Prosper, TX 75078-8885
Phone (469) 800-5200

12505 Lebanon Rd
Suite 1442
Frisco, TX 75035-8298
Phone (972) 963-3550

4001 Worth St
Dallas, TX 75246-1608

821 N Coleman St
Suite 100
Prosper, TX 75078-2339
Phone (469) 800-5200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy55
Upper gastrointestinal (GI) endoscopy for acid reflux31

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Oct 9, 2023 Accepting new patients
Healthtexas Provider Network CurrentSince Oct 9, 2023 Accepting new patients
Healthtexas Provider Network Gastroenterology Current Accepting new patients

Locations

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

Interoperability endpoints

  • Direct secure messaging: skanna1236985@direct.sw.org
  • Direct secure messaging: skanna142892@direct.ahn.org

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.

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": "1252540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1851624787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E 1ST AVE",
            "city": "TARENTUM",
            "state": "PA",
            "postal_code": "150841858",
            "telephone_number": "724-224-3113",
            "fax_number": "724-224-2447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E 1ST AVE",
            "city": "TARENTUM",
            "state": "PA",
            "postal_code": "150841858",
            "telephone_number": "724-224-3113",
            "fax_number": "724-224-2447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANNA",
        "first_name": "SOWJANYA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-10",
        "last_updated": "2022-07-21",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "MD462002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103351129",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14098931",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "skanna142892@direct.ahn.org",
            "affiliation": "N",
            "address_1": "301 E 1st Ave",
            "city": "Tarentum",
            "state": "PA",
            "country_code": "US",
            "postal_code": "150841858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tarentum, PA

Sources for this page

Verify at the official NPI Registry.