Organization Active NPI

Kumara Prathipati, M.D.,Inc

  • Internal Medicine Physician
  • San Diego, CA
National Provider Identifier
1780709345
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A40438 Issued in CA
Legal business name
KUMARA PRATHIPATI, M.D.,INC
Practice address
4276 54TH PL
#B
San Diego, CA 92115-6011
Phone
(619) 286-3222
Fax
(619) 286-3223
NPI assigned
Mar 20, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Kumara S Prathipati, M.D.NPI 1538267778
Title
President
Phone
(619) 286-3222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X A40438 CA Primary

Addresses

Primary practice location

4276 54TH PL
#B
San Diego, CA 92115-6011

Mailing address

4276 54TH PL
#B
San Diego, CA 92115-6011
Phone (619) 286-3222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041013001040 CA Part B Supplier - Clinic/Group Practice 0547220675 Receives reassigned benefits from 3 practitioners
Practice locations: National City, CA; San Diego, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0570619Kumara Prathipati4276 54TH PL, San Diego, CA 92115Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780709345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4276 54TH PL",
            "address_2": "#B",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921156011",
            "telephone_number": "619-286-3222",
            "fax_number": "619-286-3223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4276 54TH PL",
            "address_2": "#B",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921156011",
            "telephone_number": "619-286-3222",
            "fax_number": "619-286-3223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KUMARA PRATHIPATI, M.D.,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PRATHIPATI",
        "authorized_official_first_name": "KUMARA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-286-3222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A40438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.