Individual provider Active NPI

Tejanand Gowtham Mulpur, M.D.

  • Neurology Physician
  • Huntsville, AL
National Provider Identifier
1720048309
Registry record updated Sep 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
15031 Issued in AL
Practice address
201 Sivley Rd SW
St # 560
Huntsville, AL 35801-5134
Phone
(256) 265-5606
Fax
(256) 265-6561
NPI assigned
Mar 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 15031 AL Primary

Addresses

Primary practice location

201 Sivley Rd SW
St # 560
Huntsville, AL 35801-5134

Mailing address

201 Sivley Rd SW
St # 560
Huntsville, AL 35801-5134
Phone (256) 265-5606

Other identifiers 1

IdentifierTypeStateIssuer
000082289MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20061130000349 AL Practitioner - Neurology 3779581673 Reassigns benefits to 1 organization
Practice locations: Huntsville, AL

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HH Physicians NetworkGroup PAC ID 6901132448, 107 clinicians

Practice addresses (Care Compare)

101 Sivley Rd SW
Huntsville, AL 35801-4421
Phone (256) 265-1198

201 Sivley Rd SW
Suite 560
Huntsville, AL 35801-5177

201 Sivley SWRD
Suite 560
Huntsville, AL 35801-5177
Phone (256) 265-5606

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15031ALMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
HH Physicians Network Neurology CurrentSince Jul 1, 2020 Accepting new patients

Locations

101 Sivley Rd SW
Huntsville, AL 35801
Phone (256) 265-9870

1041 Balch Rd
Ste 350
Madison, AL 35758
Phone (256) 265-5951

Organizations & group practices 1

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.

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": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348790400000",
    "number": "1720048309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 SIVLEY RD SW",
            "address_2": "ST # 560",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015134",
            "telephone_number": "256-265-5606",
            "fax_number": "256-265-6561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 SIVLEY RD SW",
            "address_2": "ST # 560",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015134",
            "telephone_number": "256-265-5606",
            "fax_number": "256-265-6561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULPUR",
        "first_name": "TEJANAND",
        "middle_name": "GOWTHAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2012-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AL",
            "license": "15031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000082289",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.