Lakshmi Mudunuri, M.D.

Primary specialty

Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X

License

58025 Issued in MA

Practice address

170 Governors Ave
Medford, MA 02155-1643

Phone

(781) 306-6163

Fax

(781) 306-6146

NPI assigned

Nov 14, 2005

Last updated

May 19, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lmudunuri28813@tuftsmedicine.direct-ci.com

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.

• Hallmark Health Medical Associates Inc

  • Family Medicine Physician
  • Medford, MA
  • NPI 1770563900
  Medicare reassignment NPD
• Melrosewakefield Healthcare, Inc.

  • General Acute Care Hospital
  • Medford, MA
  • NPI 1841290467
  Medicare reassignment NPD
• Pratt Psychiatric Associates, Inc

  dba Pratt Associates

  • Psychiatry Physician
  • Boston, MA
  • NPI 1245270875
  Medicare reassignment
• Hallmark Health System Inc

  • Internal Medicine Physician
  • Medford, MA
  • NPI 1275673667

  Geriatric Psychiatry

  NPD
• Melrosewakefield Healthcare, Inc.

  • Psychiatric Hospital Unit
  • Medford, MA
  • NPI 1891835351
  NPD

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305763200000",
    "number": "1508847823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 BELLIS CIR",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021403207",
            "telephone_number": "781-306-6163",
            "fax_number": "781-306-6146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 GOVERNORS AVE",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021551643",
            "telephone_number": "781-306-6163",
            "fax_number": "781-306-6146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDUNURI",
        "first_name": "LAKSHMI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-14",
        "last_updated": "2011-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "MA",
            "license": "58025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "058025",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "15-80089",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "J06711",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3027350",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edward J Mostone, DPM
• Mountain View Therapy, LLC
• Jad Mourad
• MRNC Operating, LLC (Medford Rehabilitation & Nursing Center)
• Mt Auburn Professional Service
• Eva Muhinda
• Alissa Muller
• Christine Anne Mulligan, MD
• Kevin T Mundt, PSYD
• Joseph Robert Murano, DPM

• Geriatric Psychiatry Physician in Medford, MA
• Providers in Medford, MA by specialty
• Geriatric Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.