Roy Bharath Mukku, M.D.

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

A136888 Issued in CA

Practice address

201 S Buena Vista St Ste 100
Burbank, CA 91505-4570

Phone

(818) 848-6404

Fax

(818) 848-7112

NPI assigned

Apr 12, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Internal Medicine

Education

University of Texas Medical School at Houston, 2011

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Saint Joseph Medical Ctr Hospital, Burbank, CA, CCN 050235

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Providence Medical Institute

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1417915760

  Internal Medicine

  Medicare reassignment NPD
• Providence Medical Institute

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1235182569

  Internal Medicine

  NPD
• Providence Medical Institute

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1760425862

  Internal Medicine

  NPD
• Memorial Hospital for Cancer and Allied Diseases

  • General Acute Care Hospital
  • New York, NY
  • NPI 1700887411
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health System - Southern California

  • General Acute Care Hospital
  • Burbank, CA
  • NPI 1336173269
  Care Compare affiliation

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

{
    "created_epoch": "1302566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1265722102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S BUENA VISTA ST STE 100",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054570",
            "telephone_number": "818-848-6404",
            "fax_number": "818-848-7112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S BUENA VISTA ST STE 100",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054570",
            "telephone_number": "818-848-6404",
            "fax_number": "818-848-7112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKKU",
        "first_name": "ROY",
        "middle_name": "BHARATH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-12",
        "last_updated": "2023-02-23",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "268278",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "136888",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "A136888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gagik Movsesian, PHARMD
• Arlette Movsesyan
• MRR Foot & Ankle Inc
• MSM Health Care, Inc.
• MSP Hospice Inc
• Thomas James Muldowney, M.D.
• Nancy Mullan, M.D.
• Multi Group Home Care, Inc.
• Cecilia R Mumar
• David Valondo Mungcal, M.D.

• Interventional Cardiology Physician in Burbank, CA
• Providers in Burbank, CA by specialty
• Interventional Cardiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.