Individual provider Active NPI

Sivaji Gundlapalli, MD

  • Cardiovascular Disease Physician
  • Port Huron, MI
National Provider Identifier
1669433868
Registry record updated Jan 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
4301052256 Issued in MI
Practice address
1222 10TH Ave
Port Huron, MI 48060-3406
Phone
(810) 985-9681
Fax
(810) 985-3590
NPI assigned
Mar 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 4301052256 MI Primary

Addresses

Primary practice location

1222 10TH Ave
Port Huron, MI 48060-3406

Mailing address

1222 10TH Ave
Port Huron, MI 48060-3406
Phone (810) 985-9681

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20100709000839 MI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 1658330881 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiology Assoc of Port Huron Cardiovascular Disease CurrentSince Mar 1, 1984 Accepting new patients

Locations

1222 10th Ave
Port Huron, MI 48060
Phone (810) 985-9681

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: sivaji.gundlapalli.p1@direct.porthuronheartcenter.nextgenshare.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201651200000",
    "number": "1669433868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 10TH AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603406",
            "telephone_number": "810-985-9681",
            "fax_number": "810-985-3590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 10TH AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603406",
            "telephone_number": "810-985-9681",
            "fax_number": "810-985-3590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDLAPALLI",
        "first_name": "SIVAJI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2008-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301052256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

Verify at the official NPI Registry.