Individual provider Active NPI

Lalitha Kambhamettu, M.D.

  • Internal Medicine Physician
  • Wilmington, DE
National Provider Identifier
1558456327
Registry record updated May 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C1-0006655 Issued in DE
Practice address
102 Dominic Dr
Wilmington, DE 19808-1447
Phone
(302) 287-7506
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C1-0006655 DE Primary

Addresses

Primary practice location

102 Dominic Dr
Wilmington, DE 19808-1447

Mailing address

102 Dominic Dr
Wilmington, DE 19808-1447
Phone (302) 287-7506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20241017000825 DE Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 7719080126

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C1-0006655DEMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557705600000",
    "number": "1558456327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 DOMINIC DR",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198081447",
            "telephone_number": "302-287-7506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 DOMINIC DR",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198081447",
            "telephone_number": "302-287-7506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMBHAMETTU",
        "first_name": "LALITHA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2019-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C1-0006655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.