Alba Kamal Gandotra, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35.127084 Issued in OH

Practice address

7350 Industrial Park Blvd
Mentor, OH 44060-5318

Phone

(216) 732-9480

NPI assigned

Apr 13, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/679/brand/1/csg/319/fhir/r4

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.

• Southside Physician Network LLC

  • Internal Medicine Physician
  • Colonial Heights, VA
  • NPI 1811146194

  Family Medicine

  NPD
• Home Healthcare Services LLC

  • Home Health Agency
  • Cleveland, OH
  • NPI 1619392313
  NPD (past)

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

{
    "created_epoch": "1239580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446595200000",
    "number": "1841433448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7350 INDUSTRIAL PARK BLVD",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440605318",
            "telephone_number": "216-732-9480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7350 INDUSTRIAL PARK BLVD",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440605318",
            "telephone_number": "216-732-9480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDOTRA",
        "first_name": "ALBA",
        "middle_name": "KAMAL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-13",
        "last_updated": "2015-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101252699",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.127084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marilee Gallagher, MD
• Rachel Marie Gallup, MSSA, LSW
• Juan J Galvan, DDS
• Shilpa Gambeer Rao
• Jamie Gambrell
• Katarina K Gardner, MPH, CHES
• Jack Gareau
• Tia Gargala
• Devon Garland, RN
• Nathan T. Garner, CPRS

• Family Medicine Physician in Mentor, OH
• Providers in Mentor, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.