Individual provider Active NPI

Kalyani Gaddipati, M.D.

  • Gastroenterology Physician
  • Lake Mary, FL
National Provider Identifier
1033165964
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME74348 Issued in FL
Practice address
917 Rinehart Rd
Suite 2051
Lake Mary, FL 32746-4802
Phone
(407) 936-2444
NPI assigned
May 25, 2006
Last updated
May 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X ME74348 FL Primary

Addresses

Primary practice location

917 Rinehart Rd
Suite 2051
Lake Mary, FL 32746-4802

Mailing address

917 Rinehart Rd
Suite 2051
Lake Mary, FL 32746-4802
Phone (407) 936-2444

Other identifiers 6

IdentifierTypeStateIssuer
3542OtherFHHS
5702044007OtherCIGNA
100016196OtherRAILROAD MEDICARE
2745785OtherAETNA
254587000MedicaidFL
43554OtherBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20060221000516 FL Practitioner - Gastroenterology 3971548538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

917 Rinehart Rd
Suite 2051
Lake Mary, FL 32746-4878
Phone (321) 842-4750

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy114
Upper gastrointestinal (GI) endoscopy for acid reflux54

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME74348FLMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince May 1, 2024 Accepting new patients
Orlando Health Medical Group Inc CurrentSince May 1, 2024 Accepting new patients
Rene Ab Capulong Mdpa Past Accepting new patients
Asthma Allergy Care Center PL PastSince Dec 29, 2004 Accepting new patients

Locations

917 Rinehart Rd
Ste 2051
Lake Mary, FL 32746
Phone (407) 936-2442

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 5

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.

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1033165964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 RINEHART RD",
            "address_2": "SUITE 2051",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327464802",
            "telephone_number": "407-936-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 RINEHART RD",
            "address_2": "SUITE 2051",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327464802",
            "telephone_number": "407-936-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADDIPATI",
        "first_name": "KALYANI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME74348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FHHS",
            "identifier": "3542",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5702044007",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "100016196",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2745785",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254587000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "43554",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.