Naga Pushpa Guntupalli, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036148184 Issued in IL

Practice address

400 N Wall St Ste B402
Kankakee, IL 60901-2940

Phone

(815) 937-1237

Fax

(815) 933-0662

NPI assigned

Jun 30, 2015

Last updated

Nov 27, 2023By 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 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Psychiatry

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Riverside Health SystemGroup PAC ID 3274434717, 202 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Riverside Medical Center Hospital, Kankakee, IL, CCN 140186
• Iroquois Memorial Hospital Hospital, Watseka, IL, CCN 141353

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nguntupalli27999@direct.riversidehealthcare.net

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.

• Riverside Health System

  • General Practice Physician
  • Kankakee, IL
  • NPI 1417061193
  Medicare reassignment Care Compare group NPD
• Riverside Health System

  dba Psychiatric Associates

  • Psychiatry Physician
  • Kankakee, IL
  • NPI 1336354430
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Iroquois Memorial Hospital and Resident Home

  • Critical Access Hospital
  • Watseka, IL
  • NPI 1629003470
  Care Compare affiliation
• Riverside Medical Center

  • General Acute Care Hospital
  • Kankakee, IL
  • NPI 1538208210
  Care Compare affiliation

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

{
    "created_epoch": "1435622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1518340231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N WALL ST STE B402",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012940",
            "telephone_number": "815-937-1237",
            "fax_number": "815-933-0662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N WALL ST STE B402",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012940",
            "telephone_number": "815-937-1237",
            "fax_number": "815-933-0662"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 Butterfield Trl",
            "address_purpose": "LOCATION",
            "city": "Kankakee",
            "state": "IL",
            "postal_code": "609012959",
            "country_code": "US",
            "telephone_number": "815-936-6500",
            "fax_number": "815-936-6502",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 S Kennedy Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Bradley",
            "state": "IL",
            "postal_code": "609152686",
            "country_code": "US",
            "telephone_number": "815-937-1237",
            "fax_number": "815-933-0662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUNTUPALLI",
        "first_name": "NAGA",
        "middle_name": "PUSHPA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-30",
        "last_updated": "2023-11-27",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "262517",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036148184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036148184",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nguntupalli@rhc.net",
            "affiliation": "Y",
            "endpointDescription": "provider email address",
            "affiliationName": "Riverside Health System",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "400 N Wall St Ste B402",
            "city": "Kankakee",
            "state": "IL",
            "country_code": "US",
            "postal_code": "609012940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stephanie E Grosso, PA-C
• Grow in Illinois
• Nicholas Guastalli, DO
• Sarah Guastalli, PA-C
• Matthew Evan Guimond, NP
• Anuja Gupta, MD
• Supriya Gupta, MD
• Alicia Guttendorf
• Melanie Guzman, LCSW
• GVD Podiatry Healthcare PC

• Psychiatry Physician in Kankakee, IL
• Providers in Kankakee, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.