Individual provider Active NPI

Deepthi Devagudi, MD

  • Internal Medicine Physician
  • Anaheim, CA
National Provider Identifier
1578180618
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A186617 Issued in CA
Practice address
3033 W Orange Ave
Anaheim, CA 92804-3156
Phone
(714) 827-3000
NPI assigned
Jul 4, 2020
Last updated
Aug 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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 A186617 CA Primary

Addresses

Primary practice location

3033 W Orange Ave
Anaheim, CA 92804-3156

Mailing address

3033 W Orange Ave
Anaheim, CA 92804-3183
Phone (714) 827-3000

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
I20230728001908 CA Practitioner - Internal Medicine 3476914045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Galen Inpatient Physicians PCGroup PAC ID 3678464633, 1,045 clinicians

Practice addresses (Care Compare)

115 Mall Dr
Hanford, CA 93230-5786
Phone (559) 537-0550

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.4 of 100Reported as group
Quality
65.6
Improvement activities
40
Cost
71.06

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A186617CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Galen Inpatient Physicians PC CurrentSince Aug 1, 2023 Accepting new patients
Galen Inpatient Physicians, PC Current Accepting new patients
Galen Inpatient Physicians PC Internal Medicine CurrentSince Aug 1, 2023 Accepting new patients
Hanford Community Hospital Past Accepting new patients
Sports Medicine Grant, Inc Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

115 Mall Dr
Hanford, CA 93230
Phone (559) 537-0550

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

15248 Eleventh St
Victorville, CA 92395
Phone (760) 245-8691

Organizations & group practices 5

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 2

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": "1593820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1578180618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 W ORANGE AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043183",
            "telephone_number": "714-827-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 W ORANGE AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043156",
            "telephone_number": "714-827-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVAGUDI",
        "first_name": "DEEPTHI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-04",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A186617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.