Sumalatha M Gudavalli

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.0001545 Issued in CO

Practice address

206 W County Line Rd Ste 340
Highlands Ranch, CO 80129-2321

Phone

(303) 888-6426

Fax

(303) 302-1659

NPI assigned

Feb 27, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Alta Vista Dermatology, LLC

  dba Alta Vista Dermatology

  • Dermatology Physician
  • Highlands Ranch, CO
  • NPI 1053641381
  Medicare reassignment NPD
• Advanced Dermatology of Colorado, PC

  • Dermatology Physician
  • Fort Collins, CO
  • NPI 1710370648
  NPD (past)

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1770610719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429",
            "telephone_number": "303-493-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 W COUNTY LINE RD STE 340",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801292321",
            "telephone_number": "303-888-6426",
            "fax_number": "303-302-1659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUDAVALLI",
        "first_name": "SUMALATHA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "1545",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0001545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "98038214",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER-COMMERCIAL NUMBER",
            "identifier": "013652",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Annette Desiree Groen
• Meghan K Grove, LMFT
• Rhonda Gruchalski, M.S. CCC SLP
• Sonya Janina Gruszczynski
• Ellianna Jeanne Gubser, DDS
• Mary Elizabeth Guese, M.D.
• John A Guido Jr., DPT
• Lauren Taylor Guignon, OTD, OTR/L
• Aditi Gulabani, MD
• Gulfcoast Medical Housecalls, LLC

• Physician Assistant in Highlands Ranch, CO
• Providers in Highlands Ranch, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2026; 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.