Individual provider Active NPI

Nagamani Pullepu, M.D

  • Internal Medicine Physician
  • Lebanon, PA
National Provider Identifier
1093191140
Registry record updated Feb 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MT 208437 Issued in PA
Practice address
252 S 4TH St
Lebanon, PA 17042-6111
Phone
(717) 270-4876
NPI assigned
Jul 30, 2015
Last updated
Feb 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X MD465278 PA
Internal Medicine Physician 207R00000X MT 208437 PA Primary

Addresses

Primary practice location

252 S 4TH St
Lebanon, PA 17042-6111

Mailing address

1001 S George St
York Hospital
York, PA 17403-3676
Phone (717) 741-8003

Other practice location 1

1001 S George St
York Hospital
York, PA 17403-3676
Phone (717) 741-8003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220425002519 TX Practitioner - Internal Medicine 6709186091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ipc Healthcare Services of Texas PLLCGroup PAC ID 3971824939, 184 clinicians

Practice addresses (Care Compare)

919 E 32ND St
Austin, TX 78705-2703
Phone (512) 544-4472

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT 208437PAMDInternal Medicine Physician
MD465278PAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ipc Healthcare Services of Texas, PLLC Internal Medicine CurrentSince Mar 1, 2022 Accepting new patients
Wellspan Medical Group CurrentSince Sep 29, 2018 Accepting new patients
Wellspan Medical Group CurrentSince Sep 29, 2018 Accepting new patients
Wellspan Medical Group Current Accepting new patients
St. Davids Healthcare Partnership, L.P., LLP Past Accepting new patients

Locations

252 S 4th St
Lebanon, PA 17042
Phone (717) 270-7500

252 S 4th St
Fl 2
Lebanon, PA 17042
Phone (717) 270-3751

1001 S George St
York, PA 17403
Phone (717) 812-7687

1600 S George St
York, PA 17403
Phone (717) 848-3615

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

919 E 32nd St
Austin, TX 78705
Phone (512) 343-2466

111 Dallas St
San Antonio, TX 78205
Phone (210) 297-7000

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 3

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": "1438214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580688000000",
    "number": "1093191140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 S GEORGE ST",
            "address_2": "YORK HOSPITAL",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174033676",
            "telephone_number": "717-741-8003",
            "fax_number": "717-741-8016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 S 4TH ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170426111",
            "telephone_number": "717-270-4876"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 S George St",
            "address_2": "York Hospital",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174033676",
            "country_code": "US",
            "telephone_number": "717-741-8003",
            "fax_number": "717-741-8016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PULLEPU",
        "first_name": "NAGAMANI",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-30",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "MD465278",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT 208437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

Verify at the official NPI Registry.