Mythili Gurram, MD

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

01040824 Issued in IN

Practice address

827 S Green River Rd
Evansville, IN 47715-4105

Phone

(812) 473-7225

NPI assigned

Oct 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Allergy/ImmunologyAlso: Internal Medicine

Education

Other, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

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

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.

• Allergy and Asthma Associates of Tri-State LLC

  • Allergy & Immunology Physician
  • Evansville, IN
  • NPI 1043444755
  Medicare reassignment NPD Authorized official
• Tristate Assoc of Internal Medicine

  • Primary Care Clinic/Center
  • Evansville, IN
  • NPI 1851525539
  NPD (past)

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609372800000",
    "number": "1285722322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3276",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477313276",
            "telephone_number": "812-473-0181",
            "fax_number": "812-473-5822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 S GREEN RIVER RD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477154105",
            "telephone_number": "812-473-7225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURRAM",
        "first_name": "MYTHILI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "KY",
            "license": "36742",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "IN",
            "license": "01040824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100094590B",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mythili.gurram@aasc.eclinicaldirect.com",
            "affiliation": "N",
            "address_1": "827 S Green River Rd",
            "city": "Evansville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "477154105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Andrea Gunter, CD(DONA)
• Tonya Gunter
• Rachel Gunther, RBT
• Raghav Gupta, M.D.
• Samir K. Gupta, M.D.
• Sudheer Gurram, MD
• Laura Guse, LSW
• Kelly Guth, PT
• Mary Ellen Guthrie, NP
• James E Gutmann, MD

• Allergy & Immunology Physician in Evansville, IN
• Providers in Evansville, IN by specialty
• Allergy & Immunology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2020; 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.