Individual provider Active NPI

A Kolluru, M.D.

  • Internal Medicine Physician
  • Burbank, CA
National Provider Identifier
1598052607
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
366154 Issued in CA
Practice address
191 S Buena Vista St
Burbank, CA 91505
Phone
(818) 557-2671
NPI assigned
Jul 9, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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 366154 CA Primary

Addresses

Primary practice location

191 S Buena Vista St
Burbank, CA 91505

Mailing address

191 S Buena Vista St
Burbank, CA 91505

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
I20200305001451 CA Practitioner - Preventive Medicine 4284918152 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Preventive Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lilly Wilen MD a Medical CorporationGroup PAC ID 3072792803, 2 clinicians

Practice addresses (Care Compare)

17075 Devonshire St
Suite 306
Northridge, CA 91325-5417
Phone (818) 831-3227

Hospital & facility affiliations

  • Colby Care Home Health, Inc Home health agency, Northridge, CA, CCN 059794
  • St Elizabeth Community Hospital Hospital, Red Bluff, CA, CCN 050042

Merit-based Incentive Payment System (MIPS)

Final score
80.57 of 100Reported as group
Quality
62.42
Promoting interoperability
76
Improvement activities
40
Cost
76.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
366154CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeside Medical Organization, a Medical Group Inc. Internal Medicine CurrentSince Oct 23, 2023 Accepting new patients
Lilly Wilen M.D. a Medical Corporation CurrentSince Nov 7, 2020 Accepting new patients

Locations

191 S Buena Vista St
Ste 200
Burbank, CA 91505
Phone (818) 887-2671

8510 Balboa Blvd
Ste 150
Northridge, CA 91325
Phone (818) 637-2000

17075 Devonshire St
Ste 306
Northridge, CA 91325
Phone (818) 831-3227

Interoperability endpoints

  • Direct secure messaging: aparanjita.kolluru.p1@direct.lakeside.nextgenshare.com

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1310169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1598052607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 S BUENA VISTA ST",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "91505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 S BUENA VISTA ST",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "91505",
            "telephone_number": "818-557-2671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLURU",
        "first_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-09",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "366154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.