Complete Family Medicine PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

COMPLETE FAMILY MEDICINE PLLC

Practice address

104 Whalon St Ste 2a
Fitchburg, MA 01420-7128

Phone

(978) 345-1700

NPI assigned

Dec 9, 2021

Last updated

Feb 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Deepthi Pandraju, MDNPI 1073734901

Title

Physician

Phone

(978) 345-1700

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Deepthi Pandraju, MD

  • Family Medicine Physician
  • Fitchburg, MA
  • NPI 1073734901
  Medicare reassignment NPD Authorized official
• Vasuki Radhakrishnan, M.D.

  • Internal Medicine Physician
  • Fitchburg, MA
  • NPI 1982665089
  NPD (past)

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

{
    "created_epoch": "1639008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645401600000",
    "number": "1225797079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 WHALON ST STE 2A",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014207128",
            "telephone_number": "978-345-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 WHALON ST STE 2A",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014207128",
            "telephone_number": "978-345-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE FAMILY MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-09",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A",
        "authorized_official_last_name": "PANDRAJU",
        "authorized_official_first_name": "DEEPTHI",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "978-345-1700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Commonwealth of Massachusetts (DDS North Central Area Office)
• Community Counseling Services LLC
• Community Health Connections, Inc.
• Community Health Connections, Inc.
• Community Health Connections, Inc. (ACTION Health Services)
• Complete Physical Therapy & Wellness, LLC
• Comprehensive Outpatient Services, Inc (Riverfront Counseling Center)
• Selah Condon
• Risa Eden Connors
• Nicole Cook, MSN, PMHNP-BC

• Family Medicine Physician in Fitchburg, MA
• Providers in Fitchburg, MA by specialty
• Family Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.