NPIMap

Individual provider Active NPI

Amitha Gumidyala, PH.D.

  • Clinical Psychologist
  • Aurora, CO
National Provider Identifier
1659812949
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY.0004576 Issued in CO
Practice address
1635 Aurora CT
Aurora, CO 80045-2541
Phone
(720) 848-0000
NPI assigned
Mar 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY.0004576 CO Primary

Addresses

Primary practice location

1635 Aurora CT
Aurora, CO 80045-2541

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Other practice location 1

1055 Clermont St
116B
Denver, CO 80220-3808
Phone (303) 399-8020

Other practice location 2

12605 E 16th Ave
Aurora, CO 80045-2545
Phone (720) 848-0000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200224001761 CO Practitioner - Clinical Psychologist 6204263759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Physicians IncorporatedGroup PAC ID 3476465667, 3,189 clinicians

Practice addresses (Care Compare)

12605 E 16TH Ave
Uchealth Anschutz Medical Campus
Aurora, CO 80045-2545
Phone (720) 848-0000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY.0004576COMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians, Incorporated CurrentSince Feb 1, 2020 Accepting new patients
University Physicians Incorporated CurrentSince Feb 1, 2020 Accepting new patients

Locations

1635 Aurora Ct
Fl C305
Aurora, CO 80045

1635 Aurora Ct
Aurora, CO 80045
Phone (720) 848-1060

1635 Aurora Ct
Ste F735
Aurora, CO 80045
Phone (720) 848-2767

12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0006

1635 Aurora Ct
Fl 6
Aurora, CO 80045
Phone (720) 848-2650

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

1055 Clermont St
#116B
Denver, CO 80220

Dept 1061
Denver, CO 80256

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 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1659812949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 AURORA CT",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452541",
            "telephone_number": "720-848-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1055 Clermont St",
            "address_2": "116B",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802203808",
            "country_code": "US",
            "telephone_number": "303-399-8020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12605 E 16th Ave",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800452545",
            "country_code": "US",
            "telephone_number": "720-848-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUMIDYALA",
        "first_name": "AMITHA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-20",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY.0004576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.