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MRS. THRESIAMMA IDICHANDY NURSE PRACTITIONER
NPI 1063422319
Nurse Practitioner - Family in Richardson, TX

Active since August 09, 2006PECOS Enrolled
234 W CAMPBELL RD, RICHARDSON, TX 75080(972) 474-3221(512) 782-9316 Get Directions Write a Review

NPPES record last updated: October 7, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mrs. Thresiamma Idichandy Nurse Practitioner NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. THRESIAMMA IDICHANDY NURSE PRACTITIONER (NPI 1063422319) is an individual family provider in Richardson, Texas, licensed in Texas (1207120) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS and is a graduate of Other (2000).

NPPES Registry Identity

NPI1063422319
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. THRESIAMMA IDICHANDYCredential: NURSE PRACTITIONER
Location Address234 W CAMPBELL RDRichardson, TX 75080-3512
Mailing Address9618 Peach Tree LnRowlett, TX 75089-8508 · (248) 408-8116 · Fax (248) 408-8116
Phone(972) 474-3221
Fax(512) 782-9316
Sole ProprietorNo
Medical School CMSOtherGraduated 2000
Enumeration DateAugust 9, 2006
Last NPPES UpdateOctober 7, 2025
NPPES CertifiedOctober 7, 2025
✔ NPI 1063422319 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Licenses✔ Licensed in TX · 1207120✔ Licensed in MI · 4704171067
234 W CAMPBELL RD, Richardson, TX 75080
Open in Google Maps ↗

Other Identifiers 2

Other4704171067MI · Registered Nnurse
Other1207120TX · Texas

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Thresiamma Idichandy Nurse Practitioner is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6608011044
PECOS Enrollment IDI20251023000466
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75080 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.19 typical visit price
range $57.18 – $172.86
Typical copayment $22.04 (range $14.29 – $43.21)
Most-billed visit code 99203
Established Patient
$100.80 typical visit price
range $18.48 – $141.20
Typical copayment $25.20 (range $4.62 – $35.30)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CECILIA KWONG-MURPHY FNP - C
Nurse Practitioner (Family)
234 W CAMPBELL RD
RICHARDSON, TX 75080
Dallas County (972) 474-3221
STEPHENE SUZETTE GWINN FNP
Nurse Practitioner (Family)
234 W CAMPBELL RD
RICHARDSON, TX 75080
Dallas County (972) 474-3221
JAI GEORGY NP-C
Nurse Practitioner
234 W CAMPBELL RD
RICHARDSON, TX 75080
Dallas County (940) 758-5695
IFRA ALI PA
Physician Assistant
234 W CAMPBELL RD
RICHARDSON, TX 75080
Dallas County (972) 474-3221

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Thresiamma Idichandy's NPI number?

The NPI number for Thresiamma Idichandy is 1063422319. It was assigned to this individual provider in the NPPES registry on August 9, 2006.

Where is Thresiamma Idichandy located?

Thresiamma Idichandy practices at 234 W Campbell Rd, Richardson, TX 75080. The listed phone number is (972) 474-3221.

What is Thresiamma Idichandy's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Thresiamma Idichandy enrolled in Medicare?

Yes. Thresiamma Idichandy is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Thresiamma Idichandy was last updated on October 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.