POLAVARAPU PLASTIC SURGERY, PLLC
NPI 1982148326
Plastic Surgery in Fort Worth, TX

Q: What is Polavarapu Plastic Surgery, PLLC's NPI number?

The NPI number for Polavarapu Plastic Surgery, PLLC is 1982148326. It was assigned to this organization in the NPPES registry on December 5, 2016.

Q: What is Polavarapu Plastic Surgery, PLLC's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

Active since December 05, 2016

4455 CAMP BOWIE BLVD, SUITE 114-30, FORT WORTH, TX 76107(773) 710-6128 Get Directions Write a Review

NPPES record last updated: January 31, 2017. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 31, 2017, Dec 15, 2016 (2 updates tracked since 2016).

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About Polavarapu Plastic Surgery, Pllc NPPES

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

POLAVARAPU PLASTIC SURGERY, PLLC (NPI 1982148326) is a healthcare organization registered as a plastic surgery in Fort Worth, Texas and active in the NPI registry since December 2016. The organization lists Kiran Polavarapu, Owner, as its authorized official.

NPPES Registry Identity

NPI1982148326

Entity TypeOrganization

Primary Taxonomy208200000X

Legal Business NamePOLAVARAPU PLASTIC SURGERY, PLLC

Location Address4455 CAMP BOWIE BLVD, SUITE 114-30Fort Worth, TX 76107-3864

Mailing Address4455 Camp Bowie Blvd, Suite 114-30Fort Worth, TX 76107-3864 · (773) 710-6128

Phone(773) 710-6128

Organization SubpartNo

Authorized OfficialKiran PolavarapuOwner · (817) 615-8576

Enumeration DateDecember 5, 2016

Last NPPES UpdateJanuary 31, 20172 updates tracked since enumeration

✔ NPI 1982148326 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208200000X

License✔ Licensed in TX · Q0809

Definition

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

4455 CAMP BOWIE BLVD, Fort Worth, TX 76107

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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)

Polavarapu Plastic Surgery, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Polavarapu Plastic Surgery, PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Kiran Polavarapu, M.D.

Plastic and Reconstructive Surgery

NPI 1518139518

12001 SOUTH FWY SUITE 302
Burleson, TX 76028

(817) 615-8576

✔ PECOS✔ Accepts Medicare12 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 Polavarapu Plastic Surgery, PLLC's NPI number?

The NPI number for Polavarapu Plastic Surgery, PLLC is 1982148326. It was assigned to this organization in the NPPES registry on December 5, 2016.

Where is Polavarapu Plastic Surgery, PLLC located?

Polavarapu Plastic Surgery, PLLC is located at 4455 Camp Bowie Blvd Suite 114-30, Fort Worth, TX 76107. The listed phone number is (773) 710-6128.

What is Polavarapu Plastic Surgery, PLLC's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

Is Polavarapu Plastic Surgery, PLLC enrolled in Medicare?

Yes. Polavarapu Plastic Surgery, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Polavarapu Plastic Surgery, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Plastic and Reconstructive Surgery) reassigns their Medicare billing to Polavarapu Plastic Surgery, PLLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Polavarapu Plastic Surgery, PLLC was last updated on January 31, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.