Jane P Addagatla, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A72265 Issued in CA

Practice address

VA McClellan Opc
5342 Dudley Blvd ,BLDG 98
McClellan Park, CA 95652

Phone

(916) 561-7400

NPI assigned

Nov 29, 2005

Last updated

Jul 27, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185494400000",
    "number": "1073596581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "VA MCCLELLAN OPC",
            "address_2": "5342 DUDLEY BLVD ,BLDG 98",
            "city": "MCCLELLAN PARK",
            "state": "CA",
            "postal_code": "95652",
            "telephone_number": "916-561-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "VA MCCLELLAN OPC",
            "address_2": "5342 DUDLEY BLVD ,BLDG 98",
            "city": "MCCLELLAN PARK",
            "state": "CA",
            "postal_code": "95652",
            "telephone_number": "916-561-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADDAGATLA",
        "first_name": "JANE",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-29",
        "last_updated": "2007-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A72265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Alaka
• Alexis Jade Daniels
• Larry Wayne Hoff, PA
• Branden A Jennings
• Ava Le, PSYD

• Internal Medicine Physician in McClellan Park, CA
• Providers in McClellan Park, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.