Individual provider Active NPI

Nirmala Kethineni, M.D.

  • Internal Medicine Physician
  • Richmond, TX
National Provider Identifier
1891824686
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M1430 Issued in TX
Practice address
20675 FM 1093 Rd Ste a
Richmond, TX 77407-7778
Phone
(713) 461-2915
Fax
(713) 461-5307
NPI assigned
Mar 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M1430 TX Primary

Addresses

Primary practice location

20675 FM 1093 Rd Ste a
Richmond, TX 77407-7778

Mailing address

PO Box 392929
Pittsburgh, PA 15251-9900
Phone (713) 461-2915

Other identifiers 1

IdentifierTypeStateIssuer
199525002MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nirmala.kethineni.1@13711.direct.athenahealth.com Direct

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
I20051201000904 TX Practitioner - Internal MedicinePractitioner - Family Practice 1355361593 Reassigns benefits to 1 organization
Practice locations: Cypress, TX

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Family Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Villagemd of Southeast Texas PAGroup PAC ID 4587947346, 217 clinicians

Practice addresses (Care Compare)

6122 Broadway St
Suite 100
Pearland, TX 77581-7804
Phone (346) 398-7252

Hospital & facility affiliations

  • Accentcare Home Health of Houston - South, LLC Home health agency, Sugar Land, TX, CCN 679102

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Villagemd of Southeast Texas, PA Internal Medicine CurrentSince Jun 16, 2024 Accepting new patients
Village Family Practice, L.L.P Internal Medicine CurrentSince Feb 1, 2021 Accepting new patients
Villagemd of Southeast Texas, PA Internal Medicine CurrentSince Feb 1, 2021 Accepting new patients
Raj Associates, LLP Internal Medicine Past Accepting new patients

Locations

4650 Westway Park Blvd
Ste 210
Houston, TX 77041
Phone (346) 980-2701

9055 Katy Fwy
Ste 100
Houston, TX 77024
Phone (346) 646-4954

6122 Broadway St
#100
Pearland, TX 77581
Phone (346) 398-7252

20675 FM 1093 Rd
Richmond, TX 77407
Phone (281) 239-3772

20675 FM 1093 Rd
Ste A
Richmond, TX 77407
Phone (346) 646-3525

1321 S Byrd Ave
Shepherd, TX 77371
Phone (936) 628-1694

Interoperability endpoints

  • Direct secure messaging: nirmala.kethineni.1@13711.direct.athenahealth.com

Organizations & group practices 4

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 1

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": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1891824686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 392929",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152519900",
            "telephone_number": "713-461-2915",
            "fax_number": "713-461-5307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20675 FM 1093 RD STE A",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774077778",
            "telephone_number": "713-461-2915",
            "fax_number": "713-461-5307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETHINENI",
        "first_name": "NIRMALA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M1430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "199525002",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nirmala.kethineni.1@13711.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "20675 Fm 1093 Rd Ste A",
            "city": "Richmond",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774077778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Richmond, TX

Sources for this page

Verify at the official NPI Registry.