Deepanvita Kalvala, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301509743 Issued in MI

Practice address

3333 Glendale Ave
Toledo, OH 43614-2426

Phone

(419) 383-5502

Fax

(419) 383-5515

NPI assigned

Mar 29, 2019

Sex

Female

Sole proprietor

No

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

• Mercy Memorial Hospital Corporatio

  • General Acute Care Hospital
  • Monroe, MI
  • NPI 1811097223

  MI

  Medicare reassignment Care Compare group NPD
• Promedica Monroe Physicians

  • Family Medicine Physician
  • Toledo, OH
  • NPI 1194078055

  MI

  Medicare reassignment Care Compare group
• Mercy Memorial Hospital Corporation

  • Specialist
  • Monroe, MI
  • NPI 1376997551
  NPD
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Monroe Opco LLC

  • Skilled Nursing Facility
  • Monroe, MI
  • NPI 1740621762
  NPD (past)

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

• Custom Hospice, LLC

  • Community Based Hospice Care Agency
  • Troy, MI
  • NPI 1558613281

  Hospice

  Care Compare affiliation
• Frenchtown Acquisition Company Inc

  • Skilled Nursing Facility
  • Monroe, MI
  • NPI 1568469898

  Nursing home

  Care Compare affiliation
• Great Lakes Home Health Services, Inc.

  • Home Health Agency
  • Jackson, MI
  • NPI 1588642110
  Care Compare affiliation
• Ihm Senior Living Community, Inc.

  • Skilled Nursing Facility
  • Monroe, MI
  • NPI 1699926022

  Nursing home

  Care Compare affiliation
• Mercy Memorial Hospital Corporatio

  • General Acute Care Hospital
  • Monroe, MI
  • NPI 1811097223

  Hospital

  Care Compare affiliation
• Mercy Memorial Hospital Corporation

  • Specialist
  • Monroe, MI
  • NPI 1376997551

  Hospital

  Care Compare affiliation
• Monroe Opco LLC

  • Skilled Nursing Facility
  • Monroe, MI
  • NPI 1740621762

  Nursing home

  Care Compare affiliation

Specialty

Family Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Memorial Hospital Corporation 16 clinicians

Promedica Monroe Physicians 64 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elara Caring Home health agency, Jackson, MI, CCN 237274
• Custom Hospice, LLC Hospice, Troy, MI, CCN 231638
• Promedica Monroe Regional Hospital Hospital, Monroe, MI, CCN 230099
• Medilodge of Monroe Nursing home, Monroe, MI, CCN 235563
• IHM Senior Living Community Nursing home, Monroe, MI, CCN 235648
• Fountain View of Monroe Nursing home, Monroe, MI, CCN 235225

Medicare fee-for-service enrollment

Enrolled in MI

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

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 21, 2023.

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1124589239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 GLENDALE AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436142426",
            "telephone_number": "419-383-5502",
            "fax_number": "419-383-5515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 GLENDALE AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436142426",
            "telephone_number": "419-383-5502",
            "fax_number": "419-383-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALVALA",
        "first_name": "DEEPANVITA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-29",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301509743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Toledo, OH
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.