Individual provider Active NPI

Vinnie D Kallumadanda, MD

  • Family Medicine Physician
  • Edinburg, TX
National Provider Identifier
1912169459
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
N0872 Issued in TX
Practice address
2507 Cornerstone Blvd
Edinburg, TX 78539-8463
Phone
(956) 688-8181
Fax
(956) 688-8034
NPI assigned
Jun 26, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X N0872 TX Primary

Addresses

Primary practice location

2507 Cornerstone Blvd
Edinburg, TX 78539-8463

Mailing address

2507 Cornerstone Blvd
Edinburg, TX 78539-8463
Phone (956) 688-8181

Other practice location 1

901 E Esperanza Ave
McAllen, TX 78501-1424
Phone (956) 688-8181

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
I20090911000401 TX Practitioner - Family PracticePractitioner - Internal Medicine 2860547015 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

901 E Esperanza Ave
STM Primary Care Clinic
McAllen, TX 78501-1424
Phone (956) 688-8181

Hospital & facility affiliations

  • Doctors Hosptal at Renaissance Hospital, Edinburg, TX, CCN 450869
  • Rio Grande Regional Hospital Hospital, McAllen, TX, CCN 450711
  • South Texas Health System Hospital, Edinburg, TX, CCN 450119

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
MD Hospitalists PLLC CurrentSince Jul 17, 2019 Accepting new patients
Kallumadanda PLLC Family Medicine CurrentSince Apr 20, 2013 Accepting new patients
Cornerstone Cardio-Vascular PastSince Jan 10, 2021 Accepting new patients
Advanced Nuclear Imaging , Inc PastSince Apr 20, 2013 Accepting new patients
Humberto Nunez MD PA Family Medicine PastSince Oct 1, 2013 Accepting new patients

Locations

2507 Cornerstone Blvd
Edinburg, TX 78539
Phone (956) 688-8181

110 E Savannah Ave
Bldg B
McAllen, TX 78503
Phone (956) 686-7611

901 E Esperanza Ave
McAllen, TX 78501
Phone (956) 451-0661

Organizations & group practices 5

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": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1912169459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2507 CORNERSTONE BLVD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785398463",
            "telephone_number": "956-688-8181",
            "fax_number": "956-688-8034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2507 CORNERSTONE BLVD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785398463",
            "telephone_number": "956-688-8181",
            "fax_number": "956-688-8034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 E Esperanza Ave",
            "address_purpose": "LOCATION",
            "city": "McAllen",
            "state": "TX",
            "postal_code": "785011424",
            "country_code": "US",
            "telephone_number": "956-688-8181",
            "fax_number": "956-688-8034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KALLUMADANDA",
        "first_name": "VINNIE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-26",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N0872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinburg, TX

Sources for this page

Verify at the official NPI Registry.