Individual provider Active NPI

Srikanth Mukkera, M.D.

  • Rheumatology Physician
  • Odessa, TX
National Provider Identifier
1891006482
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
S8215 Issued in TX
Practice address
701 W 5TH St
Odessa, TX 79763-4206
Phone
(432) 335-2222
Fax
(432) 335-1815
NPI assigned
Jun 29, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X TRN15469 FL
Rheumatology Physician 207RR0500X S8215 TX Primary
Internal Medicine Physician 207R00000X S8215 TX

Addresses

Primary practice location

701 W 5TH St
Odessa, TX 79763-4206

Mailing address

701 W 5TH St
Odessa, TX 79763-4206
Phone (432) 335-2222

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
I20190930002275 TX Practitioner - RheumatologyPractitioner - Internal Medicine 1254646045 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

8050 E Hwy 191
Suite 203
Odessa, TX 79765-8615
Phone (432) 326-1939

Hospital & facility affiliations

  • Medical Center Hospital Hospital, Odessa, TX, CCN 450132
  • Midland Memorial Hospital Hospital, Midland, TX, CCN 450133
  • Pecos County Memorial Hospital Hospital, Fort Stockton, TX, CCN 451389
  • Permian Regional Medical Center Andrews County Ho Hospital, Andrews, TX, CCN 450144
  • Reeves Regional Health Hospital, Pecos, TX, CCN 451377

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TRN15469FLMDInternal Medicine Physician
S8215TXMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permian Arthritis and Rheumatology Center Rheumatology CurrentSince May 13, 2024 Accepting new patients
Texas Tech University Health Sciences Center Odessa Internal Medicine CurrentSince Aug 22, 2019 Accepting new patients

Locations

701 W 5th St
#3142
Odessa, TX 79763
Phone (432) 335-2222

701 W 5th St
Odessa, TX 79763
Phone (432) 335-2222

8050 E Highway 191
Ste 203
Odessa, TX 79765
Phone (432) 326-1939

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FHGEDD/Endpoint/FHGEDD
  • FHIR API: https://fhir4.healow.com/fhir/r4/FHGEDD

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1277769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1891006482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 W 5TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797634206",
            "telephone_number": "432-335-2222",
            "fax_number": "432-335-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W 5TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797634206",
            "telephone_number": "432-335-2222",
            "fax_number": "432-335-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKKERA",
        "first_name": "SRIKANTH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-29",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "TRN15469",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "TX",
            "license": "S8215",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "S8215",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.