Hargopal Tekumulla, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501008202 Issued in MI

Practice address

1702 Water St
Port Huron, MI 48060-4136

Phone

(810) 966-9102

Fax

(810) 966-9104

NPI assigned

Oct 25, 2006

Last updated

Nov 4, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Riverview Physical Therapy and Rehab LLCGroup PAC ID 4789690983, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Riverview Physical Therapy and Rehab,LLC

  • Physical Therapist
  • Port Huron, MI
  • NPI 1528248036
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225756800000",
    "number": "1295810851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 WATER ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480604136",
            "telephone_number": "810-966-9102",
            "fax_number": "810-966-9104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 WATER ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480604136",
            "telephone_number": "810-966-9102",
            "fax_number": "810-966-9104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEKUMULLA",
        "first_name": "HARGOPAL",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2008-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501008202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLAN OF MICHIGAN",
            "identifier": "48102",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4863011",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK, MICHIGAN",
            "identifier": "0G41113",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "650G411130",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT LAKES HEALTH PLAN",
            "identifier": "164232",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carrie Taylor, LPC
• Laura Elizabeth Taylor
• Matthew A Taylor, R.PH.
• Melissa Kay Taylor
• Sierra Skie Taylor
• Sushree Tekumulla, OT
• Telesha Temple, LBSW
• Tina Temple
• Katie Ann Tenniswood, LMT
• Rebecca Tenyer, FNP-C

• Physical Therapist in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.