Active NPI
Ramabrahmam Gullapalli, M.D.
- Anesthesiology Physician
- Fort Wayne, IN
National Provider Identifier
1811994163
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 01047905A
- Practice address
- 11109 Parkview Plaza Dr
Fort Wayne, IN 46845-1701 - Phone
- (260) 425-6030
- Fax
- (260) 425-6038
- NPI assigned
- Jul 1, 2005
- Last updated
- Apr 5, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 01047905A | IN | Primary |
Addresses
Primary practice location
11109 Parkview Plaza Dr
Fort Wayne, IN 46845-1701
Mailing address
3702 New Vision Dr BLDG B
Fort Wayne, IN 46845-1703
Phone (260) 266-6013
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200160090 | Medicaid | IN | |
| 000000082075 | Other | IN | ANTHEM BC/BS |
| 8710 | Other | IN | PHP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bloomfield Anesthesia, PC | Anesthesiology | Past | Accepting new patients |
| Preferred Anesthesia Consultants, P.C. | Anesthesiology | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Anesthesiology Physician
- Fort Wayne, IN
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- NPI 1063451839
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522886400000",
"number": "1811994163",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3702 NEW VISION DR BLDG B",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468451703",
"telephone_number": "260-266-6013",
"fax_number": "260-458-5831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11109 PARKVIEW PLAZA DR",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468451701",
"telephone_number": "260-425-6030",
"fax_number": "260-425-6038"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GULLAPALLI",
"first_name": "RAMABRAHMAM",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-01",
"last_updated": "2018-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IN",
"license": "01047905A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200160090",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC/BS",
"identifier": "000000082075",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHP",
"identifier": "8710",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.