Individual provider Active NPI

Kalyani Koduri, M.D.

  • Internal Medicine Physician
  • Houston, TX
National Provider Identifier
1982634200
Registry record updated Mar 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
L5418 Issued in TX
Practice address
5656 Kelley St
Houston, TX 77026-1967
Phone
(713) 566-5775
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X L5418 TX
Internal Medicine Physician 207R00000X L5418 TX Primary

Addresses

Primary practice location

5656 Kelley St
Houston, TX 77026-1967

Mailing address

PO Box 201088
Houston, TX 77216-1088
Phone (713) 500-3500

Other identifiers 3

IdentifierTypeStateIssuer
158331201MedicaidTX
P00023450OtherTXRAILROAD MEDICARE
8J3977OtherTXBCBS

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
I20040914000406 TX Practitioner - Internal Medicine 4082681523 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Medicine Services of TX, PLLCGroup PAC ID 3274998067, 376 clinicians

Practice addresses (Care Compare)

12141 Richmond Ave
Houston, TX 77082-2408
Phone (281) 558-3444

21214 Northwest Fwy
HCA Houston N Cypress
Cypress, TX 77429-2105
Phone (832) 912-3500

7700 Floyd Curl Dr
San Antonio, TX 78229-3902
Phone (210) 575-4000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Concord Medical Group PLLC Emergency Medicine CurrentSince Jan 19, 2018 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Internal Medicine CurrentSince Sep 1, 2016 Accepting new patients
Hospital Medicine Services of TX, PLLC CurrentSince Aug 1, 2023 Accepting new patients
Concord Medical Group of Texas PLLC Emergency Medicine CurrentSince Jan 19, 2018 Accepting new patients
Lonestar Hospital Medicine Associates, PA Emergency Medicine CurrentSince Dec 1, 2021 Accepting new patients
Rusk Physician Services PA Past Accepting new patients
KPH-Consolidation, Inc. Past Accepting new patients
Cleveland Physician Services P a Past Accepting new patients

Locations

4401 Garth Rd
Baytown, TX 77521
Phone (281) 420-8500

200 S Geneva St
Breckenridge, TX 76424
Phone (254) 559-2241

21214 Northwest Fwy
Cypress, TX 77429
Phone (832) 912-3500

125 Newman St
Fairfield, TX 75840
Phone (888) 250-2326

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

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

12141 Richmond Ave
Houston, TX 77082
Phone (281) 558-3444

22999 Highway 59 N
Kingwood, TX 77339
Phone (281) 348-3322

1717 Highway 59 Loop N
Livingston, TX 77352
Phone (936) 329-8500

1201 W Frank Ave
Lufkin, TX 75904
Phone (936) 634-8111

400 SW 25th Ave
Mineral Wells, TX 76067
Phone (940) 325-7891

2001 N Jefferson Ave
Mt Pleasant, TX 75455
Phone (903) 434-8044

11100 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 770-7000

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

305 N McKinney St
Sweeny, TX 77480
Phone (979) 548-1500

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

Organizations & group practices 8

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395619200000",
    "number": "1982634200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 201088",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772161088",
            "telephone_number": "713-500-3500",
            "fax_number": "713-500-5484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5656 KELLEY ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770261967",
            "telephone_number": "713-566-5775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KODURI",
        "first_name": "KALYANI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2014-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "L5418",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L5418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158331201",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00023450",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8J3977",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.