Gautham S Gadiraju, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301089687 Issued in MI

Practice address

400 Rosalind Redfern Grover Pkwy
Midland, TX 79701-5846

Phone

(432) 221-1111

NPI assigned

Aug 10, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Internal Medicine

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MMH PhysiciansGroup PAC ID 1759675911, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Midland Memorial Hospital Hospital, Midland, TX, CCN 450133

Merit-based Incentive Payment System (MIPS)

Final score

57.02 of 100Reported as group

Quality

21.7

Improvement activities

40

Cost

76.21

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• MMH Physicians

  • Hospitalist Physician
  • Midland, TX
  • NPI 1851764963
  Medicare reassignment Care Compare group NPD
• Midland County Hospital District

  • General Acute Care Hospital
  • Midland, TX
  • NPI 1255325817
  NPD (past)
• Apogee Medical Group Virginia, PC

  • Internal Medicine Physician
  • Scottsdale, AZ
  • NPI 1861660540
  NPD (past)
• Northeast Internal Medicine Associates, PC

  • Primary Care Nurse Practitioner
  • Lagrange, IN
  • NPI 1366859779
  NPD (past)

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

• Midland County Hospital District

  • General Acute Care Hospital
  • Midland, TX
  • NPI 1255325817
  Care Compare affiliation

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

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1649462987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4214 ANDREWS HWY STE 240",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797034817",
            "telephone_number": "432-686-6605",
            "fax_number": "432-682-2284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 ROSALIND REDFERN GROVER PKWY",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797015846",
            "telephone_number": "432-221-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADIRAJU",
        "first_name": "GAUTHAM",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-10",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301089687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000701603",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "387144401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX MEDICARE",
            "identifier": "685085",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gautham.gadiraju@midlandhealth.cernerdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "400 Rosalind Redfern Grover Pkwy",
            "city": "Midland",
            "state": "TX",
            "country_code": "US",
            "postal_code": "797015846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ashlanne Marie Fuentes, PA-S
• Daniel Romo Fuentes, LPC
• Heather Klein Fuentes, MD
• Deidra Fuller
• Andre Frank Furtado, D.P.T
• Madhavi Gadiraju, MD
• Jayme Linda Gage
• Matthew Reyes Galan
• Casey Galey, PA
• Cryatal Gallagher, PTA

• Internal Medicine Physician in Midland, TX
• Providers in Midland, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2020; 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.