Individual provider Active NPI

Peshitha Nimmagadda, MD

  • Internal Medicine Physician
  • Huntsville, AL
National Provider Identifier
1669044574
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
47772 Issued in AL
Practice address
420 Lowell Dr SE Ste 404
Huntsville, AL 35801-3754
Phone
(256) 265-9870
Fax
(256) 265-9875
NPI assigned
Jul 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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 47772 AL Primary

Addresses

Primary practice location

420 Lowell Dr SE Ste 404
Huntsville, AL 35801-3754

Mailing address

625 19TH St S
Birmingham, AL 35233-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20240816000274 AL Practitioner - Internal Medicine 5294273686 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
HH Physician CareGroup PAC ID 4082042940, 108 clinicians

Practice addresses (Care Compare)

420 Lowell Dr SE
Suite 104
Huntsville, AL 35801-3755
Phone (256) 535-5968

Hospital & facility affiliations

  • Huntsville Hospital Homecare Home health agency, Huntsville, AL, CCN 017119
  • Huntsville Hospital Hospital, Huntsville, AL, CCN 010039

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47772ALMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
HH Physician Care Internal Medicine CurrentSince Sep 1, 2024 Accepting new patients
Healthcare Authority of the City of Huntsville PastSince Sep 1, 2024 Accepting new patients

Locations

420 Lowell Dr SE
Ste 104
Huntsville, AL 35801
Phone (256) 535-5940

101 Sivley Rd SW
Huntsville, AL 35801
Phone (256) 265-9870

420 Lowell Dr SE
Ste 404
Huntsville, AL 35801
Phone (256) 265-1775

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 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": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1669044574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 19TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 LOWELL DR SE STE 404",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358013754",
            "telephone_number": "256-265-9870",
            "fax_number": "256-265-9875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIMMAGADDA",
        "first_name": "PESHITHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-12",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "47772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.