NPIMap

Individual provider Active NPI

Mamatha Gajulavarthi

  • Student in an Organized Health Care Education/Training Program
  • McKeesport, PA
National Provider Identifier
1205330107
Registry record updated Mar 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
Upmc McKeesport Internal Medicine Center
1321 Fifth Avenue
McKeesport, PA 15132
Phone
(412) 664-2782
Fax
(412) 664-2784
NPI assigned
Mar 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

Upmc McKeesport Internal Medicine Center
1321 Fifth Avenue
McKeesport, PA 15132

Mailing address

Upmc McKeesport Internal Medicine Center
1321 Fifth Avenue
McKeesport, PA 15132
Phone (412) 664-2782

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211104002986 PA Practitioner - Internal Medicine 1254720667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Keystone Rehabilitation Systems IncGroup PAC ID 7012826753, shared by 15 NPIs, 750 clinicians
Upmc Community Medicine IncGroup PAC ID 2062318975, 736 clinicians

Practice addresses (Care Compare)

203 High Pointe Dr
Suite 100
Seven Fields, PA 16046-7921
Phone (724) 742-1250

291 State Route 288
Ellwood City, PA 16117-5513
Phone (724) 752-8722

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.75 of 100Reported as group
Quality
70.53
Promoting interoperability
100
Improvement activities
40
Cost
75.31

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Community Medcine Inc CurrentSince Nov 18, 2021 Accepting new patients
Upmc Community Medicine Inc CurrentSince Nov 18, 2021 Accepting new patients
Upmc Community Medicine, Inc Current Accepting new patients
Upmc Community Medicine Inc Past Accepting new patients

Locations

291 State Route 288
Ellwood City, PA 16117
Phone (247) 752-8722

875 N Hermitage Rd
Ste 3
Hermitage, PA 16148
Phone (724) 347-4622

1321 5th Ave
McKeesport, PA 15132
Phone (412) 664-2782

2 Hot Metal St
#One
Pittsburgh, PA 15203
Phone (412) 432-5864

339 6th Ave
Fl 5
Pittsburgh, PA 15222
Phone (412) 560-8762

Interoperability endpoints

  • Direct secure messaging: mamatha.gajulavarthi@upmcdirect.com

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 and National Provider Directory roles.

Hospital & facility affiliations 11

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": "1521763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521763200000",
    "number": "1205330107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UPMC MCKEESPORT INTERNAL MEDICINE CENTER",
            "address_2": "1321 FIFTH AVENUE",
            "city": "MCKEESPORT",
            "state": "PA",
            "postal_code": "15132",
            "telephone_number": "412-664-2782",
            "fax_number": "412-664-2784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UPMC MCKEESPORT INTERNAL MEDICINE CENTER",
            "address_2": "1321 FIFTH AVENUE",
            "city": "MCKEESPORT",
            "state": "PA",
            "postal_code": "15132",
            "telephone_number": "412-664-2782",
            "fax_number": "412-664-2784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAJULAVARTHI",
        "first_name": "MAMATHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-23",
        "last_updated": "2018-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKeesport, PA

Sources for this page

Verify at the official NPI Registry.