Individual provider Active NPI

Varsha Keelara Tanguturi, M.D.

  • Internal Medicine Physician
  • Boston, MA
National Provider Identifier
1134413057
Registry record updated Apr 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
247580 Issued in MA
Practice address
75 Francis St
Boston, MA 02115-6110
Phone
(617) 732-5500
NPI assigned
Jun 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 257933 MA
Internal Medicine Physician 207R00000X 247580 MA Primary

Addresses

Primary practice location

75 Francis St
Boston, MA 02115-6110

Mailing address

55 Fruit St
Boston, MA 02114-2621
Phone (617) 726-2000

Other identifiers 1

IdentifierTypeStateIssuer
1134413057MedicaidMA

Other names 1

  • Varsha Gopalan Keelara Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20180530002125 MA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8224277736 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Harvard Medical School, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

102 Endicott St
MGH North Shore Medical
Danvers, MA 01923-3623
Phone (978) 882-6100

151 Everett Ave
Chelsea, MA 02150-1812
Phone (617) 884-8300

19 Norwood St
Everett, MA 02149-2709
Phone (617) 394-7500

25 New Chardon St
301 MGH Heart Center
Boston, MA 02114-4774
Phone (617) 726-1843

300 Ocean Ave
Revere, MA 02151-3675
Phone (781) 485-6300

385 Broadway
Revere, MA 02151-3033
Phone (617) 267-7171

388 Commonwealth Ave
Boston, MA 02215-2800
Phone (617) 267-7171

50 Staniford St
Boston, MA 02114-2517

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

57 Prospect St
Nantucket, MA 02554-2799
Phone (508) 825-8100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
247580MAMDInternal Medicine Physician
257933MAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
General Hospital Corp Current Accepting new patients
The General Hospital Corporation CurrentSince Jul 1, 2018 Accepting new patients
Massachusetts General Physicians Organization Inc Internal Medicine CurrentSince Jul 1, 2018 Accepting new patients

Locations

75 Francis St
Boston, MA 02115

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

Interoperability endpoints

  • Direct secure messaging: tanguturi.varsha.mgh@direct.partners.masshiway.net

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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": "1307491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522713600000",
    "number": "1134413057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156110",
            "telephone_number": "617-732-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANGUTURI",
        "first_name": "VARSHA",
        "middle_name": "KEELARA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-08",
        "last_updated": "2018-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MA",
            "license": "257933",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "247580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134413057",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VARSHA",
            "last_name": "KEELARA",
            "middle_name": "GOPALAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.