Individual provider Active NPI

Mythri Reddy Gollapalle

  • Family Medicine Physician
  • Fremont, CA
National Provider Identifier
1710120118
Registry record updated Jan 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A119469 Issued in CA
Practice address
39500 Liberty St
Tri-City Health Center
Fremont, CA 94538-2211
Phone
(510) 770-8040
NPI assigned
Apr 14, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A119469 CA Primary

Addresses

Primary practice location

39500 Liberty St
Tri-City Health Center
Fremont, CA 94538-2211

Mailing address

39500 Liberty St
Tri-City Health Center
Fremont, CA 94538-2211
Phone (510) 770-8040

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160819002095 CA Practitioner - Family Practice 1759608052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alameda Health SystemGroup PAC ID 3779494521, 597 clinicians

Practice addresses (Care Compare)

664 Southland Mall
Hayward, CA 94545-2150
Phone (510) 266-1700

Hospital & facility affiliations

  • Highland Hospital Hospital, Oakland, CA, CCN 050320
  • Alameda Hospital Hospital, Alameda, CA, CCN 050211

Merit-based Incentive Payment System (MIPS)

Final score
95.17 of 100Reported as group
Quality
86.93
Promoting interoperability
100
Improvement activities
40
Cost
72.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A119469CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alameda Health System CurrentSince Aug 22, 2016 Accepting new patients
Alameda Health System Current Accepting new patients
Alameda Health System CurrentSince Aug 22, 2016 Accepting new patients
Alameda Health System Past Accepting new patients

Locations

15400 Foothill Blvd
Castro Valley, CA 94578
Phone (510) 346-1468

664 Southland Mall
Hayward, CA 94545
Phone (510) 266-1700

Interoperability endpoints

  • Direct secure messaging: mgollapalle10995@alamedahs.direct-ci.com

Organizations & group practices 4

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 4

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": "1239667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391040000000",
    "number": "1710120118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39500 LIBERTY ST",
            "address_2": "TRI-CITY HEALTH CENTER",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382211",
            "telephone_number": "510-770-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39500 LIBERTY ST",
            "address_2": "TRI-CITY HEALTH CENTER",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382211",
            "telephone_number": "510-770-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLLAPALLE",
        "first_name": "MYTHRI",
        "middle_name": "REDDY",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-14",
        "last_updated": "2014-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A119469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.