Gautham Mogilishetty, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

ME129188 Issued in FL

Practice address

3400 Lee Blvd Ste 112
Lehigh Acres, FL 33971-1309

Phone

(239) 939-0999

Fax

(239) 939-1070

NPI assigned

Apr 27, 2006

Last updated

Nov 11, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

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

NephrologyAlso: Internal Medicine

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Associates in Nephrology Butcher and Devacaanthan MD PAGroup PAC ID 4587567953, 21 clinicians

Mogilishetty PLLCGroup PAC ID 0648680579, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gulf Coast Medical Center Lee Health Hospital, Fort Myers, FL, CCN 100220
• Cape Coral Hospital Hospital, Cape Coral, FL, CCN 100244
• Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gautham.mogilishetty.1@22073.direct.athenahealth.com

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.

• Mogilishetty PLLC

  • Nephrology Physician
  • Lehigh Acres, FL
  • NPI 1972117109
  Medicare reassignment Care Compare group NPD Authorized official
• Associates in Nephrology Butcher & Devacaanthan MD PA

  dba Associates in Nephrology

  • Specialist
  • Fort Myers, FL
  • NPI 1437100146
  Medicare reassignment Care Compare group NPD
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• University Internal Medicine Associates, Inc.

  • Internal Medicine Physician
  • Cincinnati, OH
  • NPI 1588620850
  NPD (past)
• University of Cincinnati Medical Center, LLC

  dba UC Health West Chester Pharmacy

  • Community/Retail Pharmacy
  • West Chester, OH
  • NPI 1912285115
  NPD (past)
• West Chester Hospital LLC

  • General Acute Care Hospital
  • West Chester, OH
  • NPI 1851549273

  Internal Medicine

  NPD (past)

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

• Lee Health System Inc

  dba Gulf Coast Medical Center

  • General Acute Care Hospital
  • Fort Myers, FL
  • NPI 1366281750
  Care Compare affiliation
• Lee Health System Inc

  dba Lee Memorial Hospital

  • General Acute Care Hospital
  • Fort Myers, FL
  • NPI 1427806025
  Care Compare affiliation
• Lee Health System Inc

  dba Cape Coral Hospital

  • General Acute Care Hospital
  • Cape Coral, FL
  • NPI 1780429076
  Care Compare affiliation

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668124800000",
    "number": "1649237314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 LEE BLVD STE 112",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339711309",
            "telephone_number": "239-939-0999",
            "fax_number": "239-939-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 LEE BLVD STE 112",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339711309",
            "telephone_number": "239-939-0999",
            "fax_number": "239-939-1070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGILISHETTY",
        "first_name": "GAUTHAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2022-11-11",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-084821",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OH",
            "license": "35-084821",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME129188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gautham.mogilishetty.1@22073.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "3400 Lee Blvd Ste 112",
            "city": "Lehigh Acres",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339711309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Grethel Miranda Diaz, RBT
• Mobil Image Radiological Services Inc.
• Mobile Labsblood Services LLC
• Katherine Mock, BCBA
• Mogilishetty PLLC
• Daniela Molina Diaz
• Dayana Molina Garcia, RBT
• Grissel Molina
• Osleydi Molina
• Giselle Molinet Valdes

• Nephrology Physician in Lehigh Acres, FL
• Providers in Lehigh Acres, FL by specialty
• Nephrology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2022; 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.