Chandra S Gottipati, MBBS

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

48897 Issued in MN

Practice address

1720 Highway 59 S
Thief River Falls, MN 56701-4331

Phone

(218) 681-4747

NPI assigned

Jan 18, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in MN, CO2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Carris Health - Redwood LLC

  • Emergency Medicine Physician
  • Redwood Falls, MN
  • NPI 1265914048

  MN

  Medicare reassignment NPD
• Lifecare Medical Center

  • Critical Access Hospital
  • Roseau, MN
  • NPI 1609861095

  MN

  Medicare reassignment NPD
• Unity Family Healthcare

  • Orthopaedic Surgery Physician
  • Little Falls, MN
  • NPI 1326234006

  MN

  Medicare reassignment NPD
• Unity Family Healthcare

  • Critical Access Hospital
  • Little Falls, MN
  • NPI 1780630939

  MN

  Medicare reassignment NPD
• Summit Medical Consultants PLLC

  • Internal Medicine Physician
  • Greenwood Village, CO
  • NPI 1265822910

  CO

  Medicare reassignment NPD
• Carris Health - Redwood LLC

  • Home Health Agency
  • Redwood Falls, MN
  • NPI 1386126167
  NPD
• Lifecare Medical Center

  • Rural Health Clinic/Center
  • Warroad, MN
  • NPI 1619724077
  NPD
• Redwood Area Hospital

  • Critical Access Hospital
  • Redwood Falls, MN
  • NPI 1487733614
  NPD
• Unity Family Healthcare

  • Clinic/Center
  • Randall, MN
  • NPI 1336359009
  NPD
• Unity Family Healthcare

  • Home Health Agency
  • Little Falls, MN
  • NPI 1952329047
  NPD

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326931200000",
    "number": "1770635682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 HIGHWAY 59 S",
            "city": "THIEF RIVER FALLS",
            "state": "MN",
            "postal_code": "567014331",
            "telephone_number": "218-683-4600",
            "fax_number": "218-681-8487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 HIGHWAY 59 S",
            "city": "THIEF RIVER FALLS",
            "state": "MN",
            "postal_code": "567014331",
            "telephone_number": "218-681-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTIPATI",
        "first_name": "CHANDRA",
        "middle_name": "S",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2012-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "48897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE",
            "identifier": "1050984",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14261",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ND BCBS",
            "identifier": "28770",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "547652000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP80578",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0127049",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• FM Ambulance Service, Inc
• Stacey Fuhrer, MPT
• Derek Gaffney, LADC, PHARMD
• Jessica Ann Gaffney, LPCC
• Karen Mae Golombecki, PSYD, LP
• Anupama Grandhi, DDS
• Great North Acupuncture LLC
• Great Plains EMS, Inc
• Sarah Omar Modawi Hamad, M.D.
• Ashley Michelle Haugen

• All providers in Thief River Falls, MN
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2012; 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.