Organization Active NPI

Ujjala Moolani, MD Inc.

  • Nephrology Physician
  • Chula Vista, CA
National Provider Identifier
1407503055
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
UJJALA MOOLANI, MD INC.
Practice address
855 Third Ave Ste 3330
Chula Vista, CA 91911-1350
Phone
(619) 745-1031
Fax
(619) 745-1032
NPI assigned
Mar 3, 2022
Last updated
Sep 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Authorized official

Name
Ujjala Moolani, MDNPI 1528221421
Title
Owner
Phone
(586) 354-8816

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

855 Third Ave Ste 3330
Chula Vista, CA 91911-1350

Mailing address

855 Third Ave Ste 3330
Chula Vista, CA 91911-1350
Phone (619) 745-1031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241003000715 CA Part B Supplier - Clinic/Group Practice 6305377243 Receives reassigned benefits from 1 practitioner
Practice locations: Chula Vista, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1646265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725580800000",
    "number": "1407503055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 THIRD AVE STE 3330",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919111350",
            "telephone_number": "619-745-1031",
            "fax_number": "619-745-1032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 THIRD AVE STE 3330",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919111350",
            "telephone_number": "619-745-1031",
            "fax_number": "619-745-1032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UJJALA MOOLANI, MD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-03",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A",
        "authorized_official_last_name": "MOOLANI",
        "authorized_official_first_name": "UJJALA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-354-8816",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.