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EAST TEXAS KIDNEY SPECIALISTS
NPI 1184689622
Internal Medicine - Nephrology in Longview, TX

Active since April 18, 2006
3535 N FOURTH ST STE 301, LONGVIEW, TX 75605(903) 234-9992(903) 234-8287 Get Directions Write a Review

NPPES record last updated: October 6, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Oct 6, 2021, Sep 17, 2021 (2 updates tracked since 2021).

About East Texas Kidney Specialists NPPES

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

EAST TEXAS KIDNEY SPECIALISTS (NPI 1184689622) is a healthcare organization registered as a nephrology in Longview, Texas and active in the NPI registry since April 2006. The organization lists Tiffany Hagood, Practice Administrator, as its authorized official.

NPPES Registry Identity

NPI1184689622
Entity TypeOrganization
Primary Taxonomy207RN0300X
Legal Business NameEAST TEXAS KIDNEY SPECIALISTS,PA
Location Address3535 N FOURTH ST STE 301Longview, TX 75605-0037
Mailing Address3535 N Fourth St Ste 301Longview, TX 75605-0037 · (903) 234-9992 · Fax (903) 234-8287
Phone(903) 234-9992
Fax(903) 234-8287
Organization SubpartNo
Authorized OfficialTiffany HagoodPractice Administrator · (903) 234-9992
Enumeration DateApril 18, 2006
Last NPPES UpdateOctober 6, 20212 updates tracked since enumeration
NPPES CertifiedOctober 6, 2021
✔ NPI 1184689622 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
3535 N FOURTH ST STE 301, Longview, TX 75605
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Other Names 1

Doing Business AsEast Texas Kidney Specialists

Other Identifiers 1

Other0035GNTX · Blue Cross & Blue Shield

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

East Texas Kidney Specialists is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

11

Medicare enrollment records show 11 clinicians reassign Medicare billing to East Texas Kidney Specialists, which bills Medicare for the services they deliver. Of these, 7 practice at this address and 9 within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 4

Nephrology7
Nurse Practitioner2
Critical Care (Intensivists)1
Internal Medicine1

Clinicians, nearest first (11)

Elizabeth Garcia, FNP
Nurse Practitioner
NPI 1962367995
3535 N FOURTH ST STE 301
Longview, TX 75605
(903) 234-9992
✔ PECOS✔ Accepts MedicareSame address
Jason Gnasigamany, DO
Nephrology
NPI 1598388308
3535 N FOURTH ST STE 301
Longview, TX 75605
(903) 234-9992
✔ PECOS✔ Accepts MedicareSame address
Glenn Mcdonald, MD
Nephrology
NPI 1336104389
3535 N FOURTH ST STE 301
Longview, TX 75605
(903) 234-9992
✔ PECOS✔ Accepts MedicareSame address
Chinmay Patel, MD
Nephrology
NPI 1164713095
3535 N FOURTH ST STE 301
Longview, TX 75605
(903) 234-9992
✔ PECOS✔ Accepts MedicareSame address
Snehal Shrivastava, M.D.
Nephrology
NPI 1669882882
3535 N FOURTH ST STE 301
Longview, TX 75605
(903) 234-9992
✔ PECOS✔ Accepts MedicareSame address
Venkatesh Reddy, MD
Internal Medicine
NPI 1891750840
3535 N FOURTH ST STE 301
Longview, TX 75605
(903) 234-9992
✔ PECOS✔ Accepts MedicareSame address
Shobha Shakamuri, MD
Nephrology
NPI 1902861446
3535 N FOURTH ST STE 301
Longview, TX 75605
(903) 234-9992
✔ PECOS✔ Accepts MedicareSame address
Rajiv Vij, M.D.
Nephrology
NPI 1386814226
103 W LOOP 281 STE 474
Longview, TX 75605
(903) 781-0455
✔ PECOS✔ Accepts Medicare1.0 mi
Holly Etheredge, APRN
Nurse Practitioner
NPI 1538878053
700 E MARSHALL AVE
Longview, TX 75601
(903) 315-1500
✔ PECOS✔ Accepts Medicare3.3 mi
Sohail Riaz, M.D.
Nephrology
NPI 1164753679
5575 WARREN PKWY STE 316
Frisco, TX 75034
(214) 579-6800
✔ PECOS✔ Accepts Medicare128 mi
Faisal Arif, M.D.
Critical Care (Intensivists)
NPI 1891927810
201 STATE ST
Erie, PA 16550
(814) 877-6000
✔ PECOS✔ Accepts Medicare1,040 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 East Texas Kidney Specialists,pa's NPI number?

The NPI number for East Texas Kidney Specialists,pa is 1184689622. It was assigned to this organization in the NPPES registry on April 18, 2006. The provider is doing business as East Texas Kidney Specialists.

Where is East Texas Kidney Specialists,pa located?

East Texas Kidney Specialists,pa is located at 3535 N Fourth St Ste 301, Longview, TX 75605. The listed phone number is (903) 234-9992.

What is East Texas Kidney Specialists,pa's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is East Texas Kidney Specialists,pa enrolled in Medicare?

Yes. East Texas Kidney Specialists,pa is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through East Texas Kidney Specialists,pa?

According to the CMS Revalidation Reassignment List (October 2026 release), 11 clinicians in 4 Medicare specialties reassign their Medicare billing to East Texas Kidney Specialists,pa. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nephrology (7), Nurse Practitioner (2) and Critical Care (Intensivists) (1). Of these, 7 practice at this address and 9 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for East Texas Kidney Specialists,pa was last updated on October 6, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.