Individual provider Active NPI

Peter Krishna Krothapalli, DO

  • Internal Medicine Physician
  • Montgomery, AL
National Provider Identifier
1285193268
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO.2975 Issued in AL
Practice address
4163 Lomac St
Montgomery, AL 36106-2881
Phone
(334) 819-4770
Fax
(888) 440-2618
NPI assigned
Mar 18, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 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 DO.2975 AL Primary

Addresses

Primary practice location

4163 Lomac St
Montgomery, AL 36106-2881

Mailing address

4163 Lomac St
Montgomery, AL 36106-2881
Phone (334) 819-4770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20221221001760 AL Practitioner - Internal Medicine 2769852490 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2101 Highland Ave S
Suite 300
Birmingham, AL 35205-4009

4163 Lomac St
Montgomery, AL 36106-2881
Phone (334) 819-4770

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Alabama Primary Care LLC Internal Medicine CurrentSince Oct 1, 2024 Accepting new patients
Primary Care Internists of Montgomery, P.C. Internal Medicine CurrentSince Dec 12, 2022 Accepting new patients

Locations

4163 Lomac St
Montgomery, AL 36106
Phone (334) 819-4770

1722 Pine St
Ste 309
Montgomery, AL 36106
Phone (334) 262-0342

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DCAGDD/Endpoint/DCAGDD
  • FHIR API: https://fhir4.healow.com/fhir/r4/DCAGDD

Organizations & group practices 2

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 5

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": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1285193268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4163 LOMAC ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361062881",
            "telephone_number": "334-819-4770",
            "fax_number": "888-440-2618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4163 LOMAC ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361062881",
            "telephone_number": "334-819-4770",
            "fax_number": "888-440-2618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROTHAPALLI",
        "first_name": "PETER",
        "middle_name": "KRISHNA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-18",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "DO.2975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.