Individual provider Active NPI

Lakshminarayana Gajula, M.D.

  • Pediatrics Physician
  • Lehighton, PA
National Provider Identifier
1184719213
Registry record updated Mar 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD022461E Issued in PA
Practice address
281 N 12TH St
Suite E
Lehighton, PA 18235-1101
Phone
(610) 377-6969
Fax
(610) 377-9099
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD022461E PA Primary

Addresses

Primary practice location

281 N 12TH St
Suite E
Lehighton, PA 18235-1101

Mailing address

PO Box 783311
Philadelphia, PA 19178-3311
Phone (484) 862-3295

Other identifiers 1

IdentifierTypeStateIssuer
000571402MedicaidPA

Other names 1

  • Dr. L.Narayana Gajula Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20190326001610 PA Practitioner - Pediatric Medicine 1456691633 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD022461EPAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Mar 4, 2019 Accepting new patients
Lehigh Valley Physician Group CurrentSince Mar 4, 2019 Accepting new patients
Lehigh Valley Physician Group Pediatrics Current Accepting new patients

Locations

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

281 N 12th St
Ste E
Lehighton, PA 18235
Phone (610) 377-6969

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1184719213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783311",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191783311",
            "telephone_number": "484-862-3295",
            "fax_number": "846-644-7659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "281 N 12TH ST",
            "address_2": "SUITE E",
            "city": "LEHIGHTON",
            "state": "PA",
            "postal_code": "182351101",
            "telephone_number": "610-377-6969",
            "fax_number": "610-377-9099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAJULA",
        "first_name": "LAKSHMINARAYANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD022461E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000571402",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "L.NARAYANA",
            "last_name": "GAJULA",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lehighton, PA

Sources for this page

Verify at the official NPI Registry.