NPIMap

Individual provider Active NPI

Dhruva Teja Tangellamudi, MD

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1245792894
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD484735 Issued in PA
Practice address
7600 Central Ave
Philadelphia, PA 19111-2442
Phone
(215) 728-2275
Fax
(215) 707-0929
NPI assigned
Apr 3, 2019
Last updated
Aug 28, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD484735 PA Primary

Addresses

Primary practice location

7600 Central Ave
Philadelphia, PA 19111-2442

Mailing address

1 Medical Center Dr
Lebanon, NH 03756-0001

Other practice location 1

1 Medical Center Dr
Lebanon, NH 03756-0001
Phone (972) 603-5319

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240308000456 NY Practitioner - Internal Medicine 1456686609
I20240603000387 PA Practitioner - Internal Medicine 1456686609 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Texas a & M University System, HSC, College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Physicians IncGroup PAC ID 2062317233, 154 clinicians

Practice addresses (Care Compare)

7600 Central Ave
Philadelphia, PA 19111-2499
Phone (215) 728-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.51 of 100Reported as group
Quality
65.57
Promoting interoperability
100
Improvement activities
40
Cost
77.55

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD484735PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Physicians Inc. CurrentSince Jun 1, 2024 Accepting new patients
Temple Physician Inc. Internal Medicine CurrentSince Jun 1, 2024 Accepting new patients
Temple Faculty Practice Plan Inc Internal Medicine CurrentSince Nov 1, 2024 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Nov 1, 2024 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Temple Physicians Inc Internal Medicine Current Accepting new patients
Temple University Hospital, Inc Past Accepting new patients
Temple University Hospital, Inc Past Accepting new patients

Locations

515 Pennsylvania Ave
Fl 2
Ft Washington, PA 19034
Phone (215) 540-0120

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

3500 N Broad St
Rm 1A
Philadelphia, PA 19140
Phone (215) 707-2433

7600 Central Ave
Philadelphia, PA 19111
Phone (215) 707-5522

8835 Germantown Ave
Philadelphia, PA 19118
Phone (215) 248-8227

Organizations & group practices 8

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 8

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": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1245792894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037560001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 CENTRAL AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112442",
            "telephone_number": "215-728-2275",
            "fax_number": "215-707-0929"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "NH",
            "postal_code": "037560001",
            "country_code": "US",
            "telephone_number": "972-603-5319",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANGELLAMUDI",
        "first_name": "DHRUVA",
        "middle_name": "TEJA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-03",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD484735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.