Venugopal Depala, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

C52648 Issued in CA

Practice address

27349 Jefferson Ave
Suite 109
Temecula, CA 92590-5634

Phone

(951) 737-5787

Fax

(951) 296-3585

NPI assigned

Sep 2, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: venugopal.depala.1@28408.direct.athenahealth.com

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.

• Moreno Valley CMHC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Moreno Valley, CA
  • NPI 1710450036
  Medicare reassignment NPD

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288656000000",
    "number": "1699877480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 892998",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925892998",
            "telephone_number": "951-737-5787",
            "fax_number": "951-296-3585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27349 JEFFERSON AVE",
            "address_2": "SUITE 109",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925905634",
            "telephone_number": "951-737-5787",
            "fax_number": "951-296-3585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPALA",
        "first_name": "VENUGOPAL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2010-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C52648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "00C526480",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gwyneth Dempsey
• Melissa Demuth, BS, SLP-A
• Trentin Javon Deneal
• Dennis a Petersen D.O. Inc
• Dennis L Huston, D.D.S, Inc
• Derm Contact PLLC
• Dermatology Specialists, Inc
• Janee Marie Derusse
• Madison Deruyter
• Desert Palm Hospice Inc

• Psychiatry Physician in Temecula, CA
• Providers in Temecula, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2010; 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.