Sumanth Mulamalla, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

01065980A Issued in IN

Practice address

15900 W 101St Ave
Dyer, IN 46311-3065

Phone

(219) 365-6333

Fax

(219) 365-8291

NPI assigned

Jun 11, 2007

Last updated

Apr 21, 2016By the provider in NPPES

Sex

Male

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 2

Medicare fee-for-service enrollment

Enrolled in IN, TN, NC, NE4 enrollments

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 4

Specialty

Nephrology

Education

Eastern Virginia Medical School, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

DLP Twin County Physician Practices LLCGroup PAC ID 7214199512, 119 clinicians

Faith Regional Health ServicesGroup PAC ID 8921902966, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Faith Health Hospital, Norfolk, NE, CCN 280125
• St Joseph Regional Medical Center Hospital, Lewiston, ID, CCN 130003
• Ozarks Healthcare Hospital, West Plains, MO, CCN 260078
• Mary Lanning Healthcare Hospital, Hastings, NE, CCN 280032

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• IL PPO Downstate
• devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
• IA HMO C-SNP
• devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
• devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
• TN PPO C-SNP
• devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3
• IA HMO
• devoted network organization-0f7f8d4f-1035-4992-8c02-dc86d12e700e
• TN PPO
• devoted network organization-92131eb0-09f2-4173-a140-cf7b381f0cf1

Interoperability endpoints

• Direct secure messaging: smulamalla@yourcarecommunity.org
• Direct secure messaging: sumanth.mulamalla.1@20919.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• DLP Twin County Physician Practices LLC

  dba Independence Family Care Center

  • Internal Medicine Physician
  • Independence, VA
  • NPI 1053687285

  NC

  Medicare reassignment Care Compare group NPD
• Faith Regional Health Services

  dba Faith Health Professional Services

  • Emergency Medicine Physician
  • Norfolk, NE
  • NPI 1104854199
  Medicare reassignment Care Compare group NPD
• National Tele-Nephrology Associates PC

  dba Ntna

  • Nephrology Physician
  • Nashville, TN
  • NPI 1235596180
  Medicare reassignment NPD
• Associates in Nephrology, S.C.

  • Nephrology Physician
  • Chicago, IL
  • NPI 1184694259

  IN

  Medicare reassignment
• Faith Regional Health Services

  dba The Pill Box

  • Community/Retail Pharmacy
  • Norfolk, NE
  • NPI 1699891465
  NPD
• Farmers Union Hospital Association

  dba Great Plains Pat Wall Clinic

  • Rural Health Clinic/Center
  • Elk City, OK
  • NPI 1114421492
  NPD
• Farmers Union Hospital Association

  dba Great Plains Regional Medical Center

  • General Acute Care Hospital
  • Elk City, OK
  • NPI 1184639122
  NPD
• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)
• Vascular Access Centers of Illinois at Morgan Park, LLC

  • Ambulatory Surgical Clinic/Center
  • Chicago, IL
  • NPI 1689163875
  NPD (past)

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

• Faith Regional Health Services

  dba Faith Health

  • General Acute Care Hospital
  • Norfolk, NE
  • NPI 1285676544
  Care Compare affiliation
• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  Care Compare affiliation
• St Joseph Hospital LLC

  • Oxygen Equipment & Supplies (DME)
  • Lewiston, ID
  • NPI 1992231799

  Hospital

  Care Compare affiliation
• St. Joseph Hospital LLC

  dba St. Joseph Regional Medical Center

  • General Acute Care Hospital
  • Lewiston, ID
  • NPI 1225090954
  Care Compare affiliation
• The Mary Lanning Memorial Hospital Association

  dba Mary Lanning Healthcare Laboratory Services

  • Clinical Medical Laboratory
  • Hastings, NE
  • NPI 1205442258

  Hospital

  Care Compare affiliation
• The Mary Lanning Memorial Hospital Association

  dba Mary Lanning Healthcare

  • Rural Acute Care Hospital
  • Hastings, NE
  • NPI 1831203488
  Care Compare affiliation

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461196800000",
    "number": "1003019647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S DESPLAINES ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606615500",
            "telephone_number": "312-654-2700",
            "fax_number": "312-654-9930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15900 W 101ST AVE",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463113065",
            "telephone_number": "219-365-6333",
            "fax_number": "219-365-8291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULAMALLA",
        "first_name": "SUMANTH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-11",
        "last_updated": "2016-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IN",
            "license": "01065980A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL MEDICARE PTAN",
            "identifier": "F400289465",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201121060A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chris J Morfas, D.D.S.
• Morley Rehabilitation Inc. (House Call Physical Therapy)
• Shkirah Moton, PHARMD.
• Danielle Moyado, OTR/L
• Emily Nicole Mrzlock, APN
• Huma Tazeem Mulk, M.D.
• Erika Mullens
• Kathryn H Mulligan, MD
• Mario Munoz
• Antoinette Marie Murphy

• Nephrology Physician in Dyer, IN
• Providers in Dyer, IN by specialty
• Nephrology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2016; 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.