Jalaja Gundrathi, M.D

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD-45745 Issued in IA

Practice address

910 N Eisenhower
Mason City, IA 50401-1525

Phone

(641) 428-5437

Fax

(641) 428-5800

NPI assigned

Jun 29, 2016

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IA, AZ2 enrollments

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 2

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• North Iowa Mercy Clinics

  dba MercyOne North Iowa Anesthesia Professional Services

  • Anesthesiology Physician
  • Mason City, IA
  • NPI 1780278242
  Medicare reassignment NPD
• Banner Childrens Banner Health Clinic LLC

  • Primary Care Clinic/Center
  • Phoenix, AZ
  • NPI 1407191216
  Medicare reassignment NPD
• North Iowa Mercy Clinics

  dba MercyOne North Iowa Family and Sports Medicine

  • Sports Medicine (Family Medicine) Physician
  • Mason City, IA
  • NPI 1982300349
  NPD
• North Iowa Mercy Clinics

  dba MercyOne Mason City Pediatric & Adolescent Clinic

  • Pediatric Adolescent Medicine Physician
  • Mason City, IA
  • NPI 1982708566
  NPD
• Banner Childrens Banner Health Clinic LLC

  • Primary Care Clinic/Center
  • Phoenix, AZ
  • NPI 1285278077
  NPD
• Banner Childrens Banner Health Clinic LLC

  • Primary Care Clinic/Center
  • Phoenix, AZ
  • NPI 1558606020
  NPD
• Banner del E Webb Medical Center

  • General Acute Care Hospital
  • Sun City West, AZ
  • NPI 1588823553
  NPD (past)
• Banner Urgent Care Services, LLC

  • Urgent Care Clinic/Center
  • Scottsdale, AZ
  • NPI 1609229764
  NPD (past)

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

{
    "created_epoch": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1699126771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S ILLINOIS AVE",
            "address_2": "SUITE 103",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504015489",
            "telephone_number": "641-428-5437",
            "fax_number": "641-428-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 N EISENHOWER",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504011525",
            "telephone_number": "641-428-5437",
            "fax_number": "641-428-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDRATHI",
        "first_name": "JALAJA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-29",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282NC2000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Children",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "MD-45745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Grimberg, MD
• Debra K Groath, ARNP
• Jennifer L Groen, PTA
• Kelly Diane Grunhovd, BA, CPS-R
• Joseph S Gullickson, DPT
• Eva Gutierrez Ackerely, TCADC
• Alysha Nicole Haaland, LMSW
• David William Haas, DC
• Richard William Haas, D.C.
• Ryan Kent Habeger, PHARM.D.

• Pediatrics Physician in Mason City, IA
• Providers in Mason City, IA by specialty
• Pediatrics Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.