Individual provider Active NPI

Roja R Mulamalla, MD

  • Cardiovascular Disease Physician
  • Farmington, UT
National Provider Identifier
1396869681
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
8332919-1205 Issued in UT
Practice address
444 W Bourne Cir Ste 200
Farmington, UT 84025
Phone
(801) 776-0174
Fax
(801) 825-3904
NPI assigned
Mar 19, 2007
Last updated
Jun 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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 8332919-1205 UT
Internal Medicine Physician 207R00000X LL1646 NV
Cardiovascular Disease Physician 207RC0000X 8332919-1205 UT Primary

Addresses

Primary practice location

444 W Bourne Cir Ste 200
Farmington, UT 84025

Mailing address

444 W Bourne Cir Ste 200
Farmington, UT 84025-3657
Phone (801) 397-3000

Other practice location 1

5682 S 3500 W Ste 2A
Roy, UT 84067-9108
Phone (801) 776-0174

Other identifiers 1

IdentifierTypeStateIssuer
100500484 GROUPMedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20160826001602 UT Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8426194093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utah Cardiology PCGroup PAC ID 6507763950, 6 clinicians

Practice addresses (Care Compare)

444 W Bourne Cir
Farmington, UT 84025-3657
Phone (801) 397-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.17 of 100Reported as apm
Quality
80.65
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting44
Pacemaker insertion or repair1-10
Varicose vein removal12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL1646NVMDInternal Medicine Physician
8332919-1205UTMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Cardiology PC Cardiovascular Disease CurrentSince Sep 1, 2016 Accepting new patients
Physician Group of Utah Inc PastSince Sep 1, 2016 Accepting new patients

Locations

520 Medical Dr
Ste 310
Bountiful, UT 84010
Phone (801) 397-3000

444 W Bourne Cir
Ste 200
Farmington, UT 84025
Phone (801) 397-3000

630 Medical Dr
North Salt Lake, UT 84010
Phone (801) 292-6231

5682 S 3500 W
#2A
Roy, UT 84067
Phone (801) 776-0174

5682 S 3500 W
Ste 2A
Roy, UT 84067
Phone (801) 776-0174

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: roja.mulamalla@direct.utahcardiology.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1396869681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 W BOURNE CIR STE 200",
            "city": "FARMINGTON",
            "state": "UT",
            "postal_code": "840253657",
            "telephone_number": "801-397-3000",
            "fax_number": "801-397-0455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 W BOURNE CIR STE 200",
            "city": "FARMINGTON",
            "state": "UT",
            "postal_code": "84025",
            "telephone_number": "801-776-0174",
            "fax_number": "801-825-3904"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5682 S 3500 W Ste 2A",
            "address_purpose": "LOCATION",
            "city": "Roy",
            "state": "UT",
            "postal_code": "840679108",
            "country_code": "US",
            "telephone_number": "801-776-0174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULAMALLA",
        "first_name": "ROJA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "8332919-1205",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "LL1646",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "UT",
            "license": "8332919-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100500484 GROUP",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, UT

Sources for this page

Verify at the official NPI Registry.