Active NPI
Mamata Gopal Majmundar, M.D.
- Family Medicine Physician
- Lexington, KY
National Provider Identifier
1245266857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 37758
- Practice address
- 1306 Versailles Rd Ste 120
Lexington, KY 40504-1795 - Phone
- (859) 259-2635
- Fax
- (859) 254-7874
- NPI assigned
- Jun 24, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 37758 | KY | Primary |
Addresses
Primary practice location
1306 Versailles Rd Ste 120
Lexington, KY 40504-1795
Mailing address
3099 Helmsdale PL
Lexington, KY 40509-2213
Phone (859) 258-6401
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 37903705 | Other | KY | MEDICAID LAB GROUP# |
| 4000501 | Other | KY | MEDICARE LAB GROUP# |
| 64066699 | Medicaid | KY | |
| P00034949 | Other | GA | RR MEDICARE PIN# |
| CB5773 | Other | GA | RR MEDICARE GROUP# |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516406400000",
"number": "1245266857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3099 HELMSDALE PL",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405092213",
"telephone_number": "859-258-6401",
"fax_number": "859-255-1480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1306 VERSAILLES RD STE 120",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405041795",
"telephone_number": "859-259-2635",
"fax_number": "859-254-7874"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAJMUNDAR",
"first_name": "MAMATA",
"middle_name": "GOPAL",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-24",
"last_updated": "2018-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KY",
"license": "37758",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID LAB GROUP#",
"identifier": "37903705",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE LAB GROUP#",
"identifier": "4000501",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64066699",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE PIN#",
"identifier": "P00034949",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE GROUP#",
"identifier": "CB5773",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.