Gautam Maddineni, M.B.B.S

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

10191 Issued in NE

Practice address

7710 Mercy Road, Suite 202
Cu Department of Gastroenterology
Omaha, NE 68124-2353

Phone

(402) 280-4191

NPI assigned

Apr 5, 2022

Sex

Male

Sole proprietor

No

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 NE

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

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751760000000",
    "number": "1710628573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7710 MERCY ROAD, SUITE 202",
            "address_2": "CU DEPARTMENT OF GASTROENTEROLOGY",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7710 MERCY ROAD, SUITE 202",
            "address_2": "CU DEPARTMENT OF GASTROENTEROLOGY",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242353",
            "telephone_number": "402-280-4191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDINENI",
        "first_name": "GAUTAM",
        "credential": "M.B.B.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-05",
        "last_updated": "2025-07-06",
        "certification_date": "2025-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NE",
            "license": "10191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lytita Madden
• Reese Madden
• Ronnell Madden
• Scott Andrew Madden, M.D.
• Whitney Madden
• Laura L Maddox, PHD
• Lillyann Maddox
• Stephanie M Maddox, APRN
• Madeleine Rose Counseling, LLC
• Deepak Madhavan, MD

• Gastroenterology Physician in Omaha, NE
• Providers in Omaha, NE by specialty
• Gastroenterology Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2025; 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.