Individual provider Active NPI

Kavya Nallamothu, MD

  • Internal Medicine Physician
  • Chevy Chase, MD
National Provider Identifier
1811526726
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0097687 Issued in MD
Practice address
8401 Connecticut Ave Ste 200
Chevy Chase, MD 20815-5829
Phone
(301) 304-8800
NPI assigned
Apr 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 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 D0097687 MD Primary

Addresses

Primary practice location

8401 Connecticut Ave Ste 200
Chevy Chase, MD 20815-5829

Mailing address

8401 Connecticut Ave Ste 200
Chevy Chase, MD 20815-5829

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, NY2 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

Enrollment IDStateProvider typePAC IDDetails
I20230912000299 DC Practitioner - Internal Medicine 4486018306 Reassigns benefits to 2 organizations
I20241007003897 NY Practitioner - Internal Medicine 4486018306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Suffolk Medical PCGroup PAC ID 0244396349, 204 clinicians

Practice addresses (Care Compare)

200 Belle Terre Rd
Port Jefferson, NY 11777-1928
Phone (631) 474-6000

Hospital & facility affiliations

  • St Charles Hospital Hospital, Port Jefferson, NY, CCN 330246

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0097687MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Suffolk, P.C CurrentSince Oct 1, 2024 Accepting new patients
Privia Care Center LLC Internal Medicine CurrentSince Aug 1, 2023 Accepting new patients
Privia Medical Group, LLC Internal Medicine CurrentSince Aug 1, 2023 Accepting new patients
Privia Medical Group, LLC CurrentSince Aug 1, 2023 Accepting new patients
Southwest Suffolk Medical, P.C. Current Accepting new patients
Southwest Suffolk Medical PC CurrentSince Oct 1, 2024 Accepting new patients
Privia Care Center LLC Internal Medicine CurrentSince Aug 1, 2023 Accepting new patients
St Charles Hospital Corp Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

4910 Massachusetts Ave NW
Ste 114
Washington, DC 20016
Phone (202) 244-0812

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

245 Old Country Rd
Melville, NY 11747
Phone (631) 465-6141

200 Belle Terre Rd
Prt Jefferson, NY 11777
Phone (631) 474-6000

48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Organizations & group practices 9

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 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": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1811526726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8401 CONNECTICUT AVE STE 200",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208155829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 CONNECTICUT AVE STE 200",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208155829",
            "telephone_number": "301-304-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NALLAMOTHU",
        "first_name": "KAVYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-02",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0097687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chevy Chase, MD

Sources for this page

Verify at the official NPI Registry.