NPIMap

Individual provider Active NPI

Devika Kommineni, MD

  • Internal Medicine Physician
  • Marlborough, MA
National Provider Identifier
1801877741
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
213080 Issued in MA
Practice address
246 Maple St
Marlborough, MA 01752-3235
Phone
(087) 860-7075
Fax
(528) 351-0173
NPI assigned
Nov 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 213080 MA Primary

Addresses

Primary practice location

246 Maple St
Marlborough, MA 01752-3235

Mailing address

171 Main St Ste 203B
Ashland, MA 01721-1187
Phone (508) 881-3029

Other identifiers 1

IdentifierTypeStateIssuer
110007912AMedicaidMA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Kommineni.Devika.CRM@direct.partners.masshiway.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070924000021 MA Practitioner - Internal Medicine 9032203922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

246 Maple St
Marlborough, MA 01752-3235
Phone (508) 460-3872

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Charles River Medical Associates PC CurrentSince Jan 1, 2016 Accepting new patients
Charles River Medical Associates PC Internal Medicine CurrentSince Jan 1, 2016 Accepting new patients
Coordinated Primary Care, Inc. Past Accepting new patients
Charles River Medical Associates, PC Past Accepting new patients
Bernard a Westerling III, MD, LLC Past Accepting new patients

Locations

171 Main St
Ste 203B
Ashland, MA 01721
Phone (508) 881-3029

571 Union Ave
Framingham, MA 01702
Phone (508) 879-8556

600 Worcester Rd
Ste 504
Framingham, MA 01702
Phone (508) 875-0922

246 Maple St
Ste 3
Marlborough, MA 01752
Phone (508) 787-3482

246 Maple St
Marlborough, MA 01752
Phone (508) 460-3872

112 Turnpike Rd
Ste 301
Westborough, MA 01581
Phone (508) 366-1550

Interoperability endpoints

  • Direct secure messaging: kommineni.devika.crm@direct.partners.masshiway.net

Organizations & group practices 5

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.

Hospital & facility affiliations 8

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": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1801877741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 MAIN ST STE 203B",
            "city": "ASHLAND",
            "state": "MA",
            "postal_code": "017211187",
            "telephone_number": "508-881-3029",
            "fax_number": "508-881-1752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 MAPLE ST",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "017523235",
            "telephone_number": "087-860-7075",
            "fax_number": "528-351-0173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMMINENI",
        "first_name": "DEVIKA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-08",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "213080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110007912A",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kommineni.Devika.CRM@direct.partners.masshiway.net",
            "affiliation": "N",
            "address_1": "246 Maple St",
            "city": "Marlborough",
            "state": "MA",
            "country_code": "US",
            "postal_code": "017523235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marlborough, MA

Sources for this page

Verify at the official NPI Registry.