Active NPI
Mumtu Sunil Lalla
- Internal Medicine Physician
- Boston, MA
National Provider Identifier
1447813399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 279959
- Practice address
- 800 Washington St
Boston, MA 02111-1552 - Phone
- (617) 636-5246
- NPI assigned
- Apr 17, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 279959 | MA | Primary |
Addresses
Primary practice location
800 Washington St
Boston, MA 02111-1552
Mailing address
111 E 210TH St
Bronx, NY 10467-2401
Other practice location 1
3401 N Broad St
Philadelphia, PA 19140-5189
Phone (215) 707-2000
Other practice location 2
111 E 210th St
Bronx, NY 10467-2401
Phone (718) 920-4321
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681776000000",
"number": "1447813399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 E 210TH ST",
"city": "BRONX",
"state": "NY",
"postal_code": "104672401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 WASHINGTON ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021111552",
"telephone_number": "617-636-5246"
}
],
"practiceLocations": [
{
"address_1": "3401 N Broad St",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191405189",
"country_code": "US",
"telephone_number": "215-707-2000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "111 E 210th St",
"address_purpose": "LOCATION",
"city": "Bronx",
"state": "NY",
"postal_code": "104672401",
"country_code": "US",
"telephone_number": "718-920-4321",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LALLA",
"first_name": "MUMTU",
"middle_name": "SUNIL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-17",
"last_updated": "2023-04-18",
"certification_date": "2023-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "279959",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.