Individual provider Active NPI

Mangayarkarasi Thandampallayam Ajjeya Gowder, MD

  • Neuro-ophthalmology Physician
  • Lexington, KY
National Provider Identifier
1710338363
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuro-ophthalmology PhysicianTaxonomy code 207WX0109X
License
57429 Issued in KY
Practice address
740 S Limestone Ste B101
Lexington, KY 40536-0001
Phone
(859) 323-5661
Fax
(859) 323-6411
NPI assigned
Jun 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 57429 KY
Student in an Organized Health Care Education/Training Program 390200000X
Neuro-ophthalmology Physician 207WX0109X 57429 KY Primary

Addresses

Primary practice location

740 S Limestone Ste B101
Lexington, KY 40536-0001

Mailing address

740 S Limestone Room L-445
University of Kentucky, Department of Neurology
Lexington, KY 40536
Phone (859) 218-5038

Other practice location 1

740 S Limestone Room L-445
University of Kentucky, Department of Neurology
Lexington, KY 40536
Phone (859) 218-5038

Other practice location 2

2799 W Grand Blvd
Henry Ford Hospital, Medical Education Department
Detroit, MI 48202-2608
Phone (313) 916-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20230622003046 KY Practitioner - OphthalmologyPractitioner - Neurology 1456719400 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
OphthalmologyAlso: Neurology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kentucky Medical Services Foundation, IncGroup PAC ID 5698689909, 949 clinicians

Practice addresses (Care Compare)

740 S Limestone St
Lexington, KY 40508-1683
Phone (859) 257-8562

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.77 of 100Reported as group
Quality
68.25
Promoting interoperability
100
Improvement activities
40
Cost
72.39

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Kentucky CurrentSince Jun 14, 2023 Accepting new patients
Kentucky Medical Services Foundation, Inc Neurology CurrentSince Jun 14, 2023 Accepting new patients
University of Kentucky Past Accepting new patients

Locations

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

Interoperability endpoints

  • Direct secure messaging: mthandampallayamajjeya21199@ukhcdirect.org

Organizations & group practices 3

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 1

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": "1466726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1710338363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 S LIMESTONE ROOM L-445",
            "address_2": "UNIVERSITY OF KENTUCKY, DEPARTMENT OF NEUROLOGY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40536",
            "telephone_number": "859-218-5038",
            "fax_number": "859-257-0754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 S LIMESTONE STE B101",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360001",
            "telephone_number": "859-323-5661",
            "fax_number": "859-323-6411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "740 S Limestone Room L-445",
            "address_2": "University of Kentucky, Department of Neurology",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "40536",
            "country_code": "US",
            "telephone_number": "859-218-5038",
            "fax_number": "859-257-0754",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2799 W Grand Blvd",
            "address_2": "Henry Ford Hospital, Medical Education Department",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482022608",
            "country_code": "US",
            "telephone_number": "313-916-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THANDAMPALLAYAM AJJEYA GOWDER",
        "first_name": "MANGAYARKARASI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-24",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "KY",
            "license": "57429",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207WX0109X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Neuro-ophthalmology",
            "state": "KY",
            "license": "57429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.