Individual provider Active NPI

Kiran Gollapudi, MD

  • Urology Physician
  • Los Angeles, CA
National Provider Identifier
1548537335
Registry record updated Nov 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
A112402 Issued in CA
Practice address
UCLA Urology 10833 Le Conte Ave
66-124 CHS
Los Angeles, CA 90095-0001
Phone
(310) 825-6301
NPI assigned
Nov 21, 2011
Last updated
Nov 21, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X A112402 CA Primary

Addresses

Primary practice location

UCLA Urology 10833 Le Conte Ave
66-124 CHS
Los Angeles, CA 90095-0001

Mailing address

3780 Keystone Ave Apt 414
Los Angeles, CA 90034-6364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20190819001977 CA Order and Referring Only - UrologyPractitioner - Urology 7911124284

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
112402CAMDDentist
A112402CAMDUrology Physician

NPI Registry JSON

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

{
    "created_epoch": "1321833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321833600000",
    "number": "1548537335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3780 KEYSTONE AVE APT 414",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900346364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UCLA UROLOGY 10833 LE CONTE AVE",
            "address_2": "66-124 CHS",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900950001",
            "telephone_number": "310-825-6301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLLAPUDI",
        "first_name": "KIRAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-21",
        "last_updated": "2011-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "A112402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.