Individual provider Active NPI

Rahul Kumar Vangala, M.D.

  • Allergy & Immunology Physician
  • Macon, GA
National Provider Identifier
1366499246
Registry record updated May 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
39257 Issued in GA
Practice address
3964 Elnora Dr
Macon, GA 31210-1825
Phone
(478) 477-1777
Fax
(478) 477-1779
NPI assigned
May 27, 2006
Last updated
May 14, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 39257 GA Primary

Addresses

Primary practice location

3964 Elnora Dr
Macon, GA 31210-1825

Mailing address

3964 Elnora Dr
Macon, GA 31210-1825
Phone (478) 477-1777

Other names 1

  • Dr. Rahul K Vangala Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20070416000251 GA Practitioner - Allergy/Immunology 7315042611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3964 Elnora Dr
Macon, GA 31210-1825

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39257GAMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy & Asthma Clinics of Ga Allergy & Immunology PastSince Sep 13, 2021 Accepting new patients
Middle Georgia Allergy Asthma and Immunology Center LLC Allergy & Immunology Past Accepting new patients

Interoperability endpoints

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

Organizations & group practices 3

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 2

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": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431561600000",
    "number": "1366499246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3964 ELNORA DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312101825",
            "telephone_number": "478-477-1777",
            "fax_number": "478-477-1779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3964 ELNORA DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312101825",
            "telephone_number": "478-477-1777",
            "fax_number": "478-477-1779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANGALA",
        "first_name": "RAHUL",
        "middle_name": "KUMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2015-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "GA",
            "license": "39257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAHUL",
            "last_name": "VANGALA",
            "middle_name": "K",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.