Sridevi Mukkamala, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

002389 Issued in NY

Practice address

909 N Washington Ave
Suite 115
Dallas, TX 75246-1520

Phone

(214) 820-9305

Fax

(214) 820-9369

NPI assigned

Jun 27, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Electronic endpoints 1

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

Specialty

Physical Medicine and Rehabilitation

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baylor University Medical Center Hospital, Dallas, TX, CCN 450021
• Baylor Scott and White Medical Center Lake Pointe Hospital, Rowlett, TX, CCN 450742
• Baylor Scott & White Institute for Rehabilitation Inpatient rehabilitation facility, Dallas, TX, CCN 453036

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smukkamala225573@direct.sw.org

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.

• Healthtexas Provider Network

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1760488936

  Physical Medicine & Rehabilitation

  Medicare reassignment Care Compare group NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Plano, TX
  • NPI 1003811639

  Physical Medicine & Rehabilitation

  NPD
• Healthtexas Provider Network

  • Anesthesiology Physician
  • Lakeway, TX
  • NPI 1104714583
  NPD

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

• Baylor University Medical Center

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1447250253
  Care Compare affiliation
• Bir JV LLP

  • Rehabilitation Hospital
  • Dallas, TX
  • NPI 1538465901

  Inpatient rehabilitation facility

  Care Compare affiliation
• Lake Pointe Operating Company, LLC

  • General Acute Care Hospital
  • Rowlett, TX
  • NPI 1205018439
  Care Compare affiliation

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1982631727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 N WASHINGTON AVE",
            "address_2": "SUITE 115",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461520",
            "telephone_number": "214-820-9305",
            "fax_number": "214-820-9369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 N WASHINGTON AVE",
            "address_2": "SUITE 115",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461520",
            "telephone_number": "214-820-9305",
            "fax_number": "214-820-9369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKKAMALA",
        "first_name": "SRIDEVI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "002389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "8CL085",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02673949",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "217154801",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMP",
            "identifier": "L023895WCPMR",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smukkamala225573@direct.sw.org",
            "affiliation": "N",
            "address_1": "411 N Washington Ave Ste 5000",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752461792",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• John Robert Muir, M.D.
• Anna Marie Mukalel, RN
• Lillian T Mukasa
• Fatima Khuzema Mukhi
• Salome Wangui Mukiri, RN
• Venkata Marthanda Sastry Mukkavilli, MD
• Eduardo Mulanovich, MD
• Mary Patricia Mulcahy, LPC
• Maximilian Mulder Corrochano, M.D.
• Jessica Berenice Muldoon

• Physical Medicine & Rehabilitation Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Physical Medicine & Rehabilitation Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; 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.