Preetam Gongidi, D.O., M.H.S.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

R3089 Issued in TX

Practice address

815 Pennsylvania Ave
Fort Worth, TX 76104-2224

Phone

(817) 321-0300

NPI assigned

May 23, 2011

Last updated

Jun 20, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, MS, LA3 enrollments

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 3

Specialty

Diagnostic Radiology

Education

Other, 2011

Medicare assignment

May accept Medicare assignment

Group practices

Ochsner Clinic LLCGroup PAC ID 8224933619, 2,845 clinicians

Crawford Andrews and Davis PTRGroup PAC ID 6507814084, 47 clinicians

Radiology Associates of North Texas PAGroup PAC ID 7911897301, 340 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Mansfield Medical Center Hospital, Mansfield, TX, CCN 670023
• Northwest Texas Hospital Hospital, Amarillo, TX, CCN 450209
• Cook Childrens Medical Center Hospital, Fort Worth, TX, CCN 453300
• Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102
• Christus St Michael Health System Hospital, Texarkana, TX, CCN 450801

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pgongidi33339@cookchildrens.direct-ci.com

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.

• Crawford Andrews & Davis PTR

  dba Radiology Associates, L.L.P.

  • Diagnostic Radiology Physician
  • Beaumont, TX
  • NPI 1952325573
  Medicare reassignment Care Compare group NPD
• Radiology Associates of North Texas PA

  • Diagnostic Radiology Physician
  • Fort Worth, TX
  • NPI 1710970975

  Pediatric Radiology

  Medicare reassignment Care Compare group NPD
• Ochsner Clinic LLC

  • General Practice Physician
  • New Orleans, LA
  • NPI 1538151428
  Medicare reassignment Care Compare group NPD
• Methodist-Cdi

  dba RAYUS Radiology

  • Diagnostic Radiology Physician
  • Plano, TX
  • NPI 1164829214
  Medicare reassignment NPD
• North Star Diagnostic Imaging, LLC

  • Radiology Clinic/Center
  • Plano, TX
  • NPI 1467787739
  Medicare reassignment NPD
• Ochsner Mississippi, LLC

  • Internal Medicine Physician
  • Bay Saint Louis, MS
  • NPI 1538674239
  Medicare reassignment NPD
• United Imaging Consultants, LLC

  • Diagnostic Radiology Physician
  • Lenexa, KS
  • NPI 1588669766

  TX

  Medicare reassignment NPD
• North Star FP, LP

  dba North Star Diagnostic Imaging

  • Radiology Clinic/Center
  • Dallas, TX
  • NPI 1033630835
  Medicare reassignment
• North Star MCD, LLC

  dba North Stat Diagnostic Imaging

  • Radiology Clinic/Center
  • Plano, TX
  • NPI 1295496602
  Medicare reassignment
• Center for Molecular Imaging Limited Partnership

  dba Southwest Diagnostic Center for Molecular Imaging

  • Radiology Clinic/Center
  • Dallas, TX
  • NPI 1568468676
  NPD
• Health Imaging Partners LLC

  dba Envision Imaging of Dallas

  • Physiological Laboratory
  • Dallas, TX
  • NPI 1144550369

  Diagnostic Radiology

  NPD
• Health Imaging Partners LLC

  dba Envision Imaging of McKinney

  • Physiological Laboratory
  • McKinney, TX
  • NPI 1215359401

  Diagnostic Radiology

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Christus Health Ark-la-Tex

  dba Christus St. Michael Health System

  • General Practice Physician
  • Texarkana, TX
  • NPI 1184623266

  Hospital

  Care Compare affiliation
• Christus Health Ark-la-Tex

  dba CHRISTUS St. Michael Health System

  • General Acute Care Hospital
  • Texarkana, TX
  • NPI 1295736734
  Care Compare affiliation
• Cook Children's Medical Center

  dba Cook Childrens Urgent Care Southlake

  • Urgent Care Clinic/Center
  • Southlake, TX
  • NPI 1134422884

  Hospital

  Care Compare affiliation
• Cook Children's Medical Center

  dba Dodson Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Fort Worth, TX
  • NPI 1720059785

  Hospital

  Care Compare affiliation
• Cook Children's Medical Center

  • Children's Hospital
  • Fort Worth, TX
  • NPI 1891765178
  Care Compare affiliation
• Methodist Hospitals of Dallas

  dba Methodist Mansfield Medical Center

  • General Acute Care Hospital
  • Mansfield, TX
  • NPI 1689629941
  Care Compare affiliation
• Mother Frances Hospital Regional Health Care Center

  dba Christus Mother Frances Hospital Tyler

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1679578439
  Care Compare affiliation
• Northwest Texas Healthcare System Inc

  dba Northwest Texas Healthcare System

  • General Acute Care Hospital
  • Amarillo, TX
  • NPI 1467442418
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1306108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1902199185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 W CANNON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043146",
            "telephone_number": "817-321-0937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 PENNSYLVANIA AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042224",
            "telephone_number": "817-321-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONGIDI",
        "first_name": "PREETAM",
        "name_prefix": "Dr.",
        "credential": "D.O., M.H.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-23",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "PA",
            "license": "OT016084",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MS",
            "license": "34798",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "LA",
            "license": "345512",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "R3089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Gomez, PHARMD
• Kirsten A Gomez, LCSW
• Stephanie Marie Gomez, LCSW
• Anjaunette Denise Gonder, LMSW
• Grace K Gongidi, PA
• Jessica A Gonzales-Latchaw, LPC
• Amanda Danette Gonzales, O.D.
• Christopher Ray Gonzales, M.D.
• David T Gonzales, PA
• Jaime Gonzales

• Diagnostic Radiology Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Diagnostic Radiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.