NPIMap

Individual provider Active NPI

Gopala Krishna Yadavalli, MD

  • Infectious Disease Physician
  • Boston, MA
National Provider Identifier
1518057728
Registry record updated Apr 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
250129 Issued in MA
Practice address
88 E Newton St
Evans 113
Boston, MA 02118-2308
Phone
(617) 638-8005
Fax
(617) 638-8728
NPI assigned
Oct 16, 2006
Last updated
Apr 2, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 250129 MA Primary
Internal Medicine Physician 207R00000X 250129 MA

Addresses

Primary practice location

88 E Newton St
Evans 113
Boston, MA 02118-2308

Mailing address

720 Harrison Ave
Dob 5
Boston, MA 02118-2371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120412000766 MA Practitioner - Infectious Disease 4981865276 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Jefferson Medical College of Thomas Jefferson University, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Evans Medical Foundation IncGroup PAC ID 7416946546, 525 clinicians

Practice addresses (Care Compare)

88 E Newton St
Boston, MA 02118-2308
Phone (617) 414-5405

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
250129MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Medical Center Corporation Current Accepting new patients
Evans Medical Foundation, Inc. Internal Medicine CurrentSince Feb 23, 2012 Accepting new patients

Locations

720 Harrison Ave
#5
Boston, MA 02118
Phone 61741454052

850 Harrison Ave
#7
Boston, MA 02118
Phone (617) 638-6837

88 East Newton St
#113
Boston, MA 02118
Phone (617) 638-8005

88 Newton St
Boston, MA 02118
Phone (617) 638-7350

Interoperability endpoints

  • Direct secure messaging: gyadavalli12539@direct.bmc.masshiway.net

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 8

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396396800000",
    "number": "1518057728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 HARRISON AVE",
            "address_2": "DOB 5",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 E NEWTON ST",
            "address_2": "EVANS 113",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182308",
            "telephone_number": "617-638-8005",
            "fax_number": "617-638-8728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YADAVALLI",
        "first_name": "GOPALA",
        "middle_name": "KRISHNA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2014-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MA",
            "license": "250129",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "250129",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.