Individual provider Active NPI

Megha Adusumalli, MD

  • Family Medicine Physician
  • Gahanna, OH
National Provider Identifier
1164915575
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35.151064 Issued in OH
Practice address
1075 Beecher Xing N
Gahanna, OH 43230-4572
Phone
(614) 685-1985
Fax
(614) 688-6280
NPI assigned
Jun 11, 2018
Last updated
Jun 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-157620 IL
Family Medicine Physician 207Q00000X 35.151064 OH Primary

Addresses

Primary practice location

1075 Beecher Xing N
Gahanna, OH 43230-4572

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 685-1985

Other practice location 1

2535 South Martin Luther King Drive
chicago, IL 60616
Phone (312) 842-7117

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address madusumalli313829@direct.myadvocateaurora.org Direct
FHIR URL https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20240703001734 OH Practitioner - Family Practice 6800132333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osup Community Outreach LLCGroup PAC ID 5799008082, 147 clinicians

Practice addresses (Care Compare)

6100 N Hamilton Rd
Westerville, OH 43081-2062
Phone (614) 293-4969

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-157620ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osup Community Outreach LLC CurrentSince Jun 1, 2024 Accepting new patients

Locations

700 Ackerman Rd
Ste 2120
Columbus, OH 43202

6100 N Hamilton Rd
Westerville, OH 43081
Phone (614) 814-8100

Interoperability endpoints

  • Direct secure messaging: madusumalli1224392@direct.osumc.edu
  • Direct secure messaging: madusumalli313829@direct.myadvocateaurora.org

Organizations & group practices 1

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 4

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": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1164915575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-685-1985",
            "fax_number": "614-688-6280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 BEECHER XING N",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432304572",
            "telephone_number": "614-685-1985",
            "fax_number": "614-688-6280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2535 South Martin Luther King Drive",
            "address_purpose": "LOCATION",
            "city": "chicago",
            "state": "IL",
            "postal_code": "60616",
            "country_code": "US",
            "telephone_number": "312-842-7117",
            "fax_number": "312-326-2102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADUSUMALLI",
        "first_name": "MEGHA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-157620",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.151064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "madusumalli313829@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2535 South Martin Luther King Drive",
            "city": "chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2535 South Martin Luther King Drive",
            "city": "chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gahanna, OH

Sources for this page

Verify at the official NPI Registry.