Active NPI
Malati V Pamulapati, MD
- Family Medicine Physician
- Mankato, MN
National Provider Identifier
1477667814
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 49206
- Practice address
- 1230 E. Main Street
Mankato Clinic @ Main Street
Mankato, MN 56002-8674 - Phone
- (507) 625-1811
- Fax
- (507) 231-6376
- NPI assigned
- Aug 19, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | 49206 | MN | |
| Family Medicine Physician | 207Q00000X | 49206 | MN | Primary |
| Specialist | 174400000X | 31199 | IA |
Addresses
Primary practice location
1230 E. Main Street
Mankato Clinic @ Main Street
Mankato, MN 56002-8674
Mailing address
PO Box 8674 1230 E. Main Street
Mankato Clinic, LTD
Mankato, MN 56002-8674
Phone (507) 625-1811
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1111435 | Medicaid | IA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | malatipamulapati@mklt.allscriptsdirect.net | Direct |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31199 | IA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594771200000",
"number": "1477667814",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8674 1230 E. MAIN STREET",
"address_2": "MANKATO CLINIC, LTD",
"city": "MANKATO",
"state": "MN",
"postal_code": "560028674",
"telephone_number": "507-625-1811",
"fax_number": "507-231-6376"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1230 E. MAIN STREET",
"address_2": "MANKATO CLINIC @ MAIN STREET",
"city": "MANKATO",
"state": "MN",
"postal_code": "560028674",
"telephone_number": "507-625-1811",
"fax_number": "507-231-6376"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAMULAPATI",
"first_name": "MALATI",
"middle_name": "V",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-19",
"last_updated": "2020-07-15",
"certification_date": "2020-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "207QG0300X",
"taxonomy_group": "",
"desc": "Family Medicine, Geriatric Medicine",
"state": "MN",
"license": "49206",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "49206",
"primary": true
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "IA",
"license": "31199",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1111435",
"state": "IA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "malatipamulapati@mklt.allscriptsdirect.net",
"affiliation": "N",
"endpointDescription": "Mankato Clinic Direct ID, Allscripts Community",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1230 E. Main Street",
"address_2": "Mankato Clinic @ Main Street",
"city": "Mankato",
"state": "MN",
"country_code": "US",
"postal_code": "560028674",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Mankato, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.