NPIMap

Individual provider Active NPI

Mallika Kuruba, MD

  • Family Medicine Physician
  • Dallas, TX
National Provider Identifier
1932333705
Registry record updated Feb 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
P7487 Issued in TX
Practice address
3560 W Camp Wisdom Rd
Dallas, TX 75237-2506
Phone
(214) 266-5000
NPI assigned
May 8, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MT194373 PA
Family Medicine Physician 207Q00000X P7487 TX Primary

Addresses

Primary practice location

3560 W Camp Wisdom Rd
Dallas, TX 75237-2506

Mailing address

PO Box 660599
Dallas, TX 75266-0599

Other identifiers 2

IdentifierTypeStateIssuer
325865901MedicaidTX
8DZ257OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131028000753 TX Practitioner - Family Practice 1052546199 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dallas County Hospital DistrictGroup PAC ID 8325934813, 597 clinicians

Practice addresses (Care Compare)

5200 Harry Hines Blvd
Dallas, TX 75235-7709
Phone (214) 590-8006

Hospital & facility affiliations

  • Parkland Health & Hospital System Hospital, Dallas, TX, CCN 450015

Merit-based Incentive Payment System (MIPS)

Final score
95.1 of 100Reported as group
Quality
88.97
Promoting interoperability
79
Improvement activities
40
Cost
83.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT194373PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas County Hospital District Family Medicine CurrentSince Dec 15, 2021 Accepting new patients
Dallas County Hospital District CurrentSince Dec 15, 2021 Accepting new patients
Acclaim Physician Group, Inc CurrentSince May 1, 2016 Accepting new patients
Dallas County Hospital District CurrentSince Dec 15, 2021 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Family Medicine CurrentSince Jan 1, 2018 Accepting new patients

Locations

601 E 15th St
Austin, TX 78701
Phone (512) 324-7868

3201 W State Highway 22
Corsicana, TX 75110
Phone (903) 654-6800

9202 Elam Rd
Fl 1
Dallas, TX 75217
Phone (214) 266-1500

3560 W Camp Wisdom Rd
Ste 100
Dallas, TX 75237
Phone (214) 266-4000

4201 Brook Spring Dr
Bldg I
Dallas, TX 75224
Phone (214) 266-1450

1350 S Main St
Fl 1
Fort Worth, TX 76104
Phone (817) 702-3701

1513 E Presidio St
Fort Worth, TX 76102
Phone (817) 702-3101

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

855 Montgomery St
Ft Worth, TX 76107
Phone (817) 735-2334

7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

1800 N Britain Rd
Irving, TX 75061
Phone (214) 266-3000

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

Interoperability endpoints

  • Direct secure messaging: mkuruba278555@direct.phhs.org

Organizations & group practices 6

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 45

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

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1241740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1932333705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660599",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752660599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3560 W CAMP WISDOM RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752372506",
            "telephone_number": "214-266-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURUBA",
        "first_name": "MALLIKA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-08",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MT194373",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P7487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "325865901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8DZ257",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.