NPIMap

Individual provider Active NPI

Deepthi Kagolanu, M.D.

  • Internal Medicine Physician
  • East Meadow, NY
National Provider Identifier
1396130530
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
61951 Issued in CT
Practice address
2201 Hempstead Tpke
East Meadow, NY 11554-1859
Phone
(949) 981-8781
NPI assigned
Apr 4, 2015
Last updated
Mar 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DR.0070217 CO
Internal Medicine Physician 207R00000X 61951 CT Primary
Gastroenterology Physician 207RG0100X DR.0070217 CO

Addresses

Primary practice location

2201 Hempstead Tpke
East Meadow, NY 11554-1859

Mailing address

2201 Hempstead Tpke
East Meadow, NY 11554-1859
Phone (516) 296-3349

Other practice location 1

80 Health Park Dr Ste 270
Louisville, CO 80027-4644
Phone (303) 269-2085

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230421002619 CO Practitioner - GastroenterologyPractitioner - Internal Medicine 1557615754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

80 Health Park Dr
Suite 270
Louisville, CO 80027-4644
Phone (303) 269-2085

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.96 of 100Reported as group
Quality
78.58
Promoting interoperability
100
Improvement activities
40
Cost
74.61

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy36
Upper gastrointestinal (GI) endoscopy for acid reflux39

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Midstate Medical Center Current Accepting new patients
Portercare Adventist Health System Current Accepting new patients
Portercare Adventist Health System CurrentSince Jun 1, 2023 Accepting new patients
Portercare Adventist Health System CurrentSince Jun 1, 2023 Accepting new patients
Portercare Adventist Health System Past Accepting new patients

Locations

9100 E Mineral Cir
Centennial, CO 80112
Phone (303) 561-5193

7750 S Broadway
Ste 260
Littleton, CO 80122
Phone (303) 734-8650

80 Health Park Dr
Ste 270
Louisville, CO 80027
Phone (303) 269-2085

7233 Church Ranch Blvd
Westminster, CO 80021
Phone (303) 925-4137

435 Lewis Ave
Meriden, CT 06451
Phone (203) 284-1340

Interoperability endpoints

  • Direct secure messaging: dkagolanu2043823@adventhealth.direct-ci.com

Organizations & group practices 5

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 9

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": "1428105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1396130530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 HEMPSTEAD TPKE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541859",
            "telephone_number": "516-296-3349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 HEMPSTEAD TPKE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541859",
            "telephone_number": "949-981-8781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Health Park Dr Ste 270",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "CO",
            "postal_code": "800274644",
            "country_code": "US",
            "telephone_number": "303-269-2085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAGOLANU",
        "first_name": "DEEPTHI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-04",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0070217",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "61951",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CO",
            "license": "DR.0070217",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Meadow, NY

Sources for this page

Verify at the official NPI Registry.