NPIMap

Organization Active NPI

Elite Health Associates LLC

  • Internal Medicine Physician
  • Shrewsbury, MA
National Provider Identifier
1851718779
Registry record updated Apr 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
241829 Issued in MA
Legal business name
ELITE HEALTH ASSOCIATES LLC
Practice address
602 Avalon Way
Shrewsbury, MA 01545-7804
Phone
(917) 319-9180
NPI assigned
Mar 28, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2014

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

Authorized official

Name
Suresh Mamidala, MD
Title
President
Phone
(917) 319-9180

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X 241829 MA Primary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X 240724 MA

Addresses

Primary practice location

602 Avalon Way
Shrewsbury, MA 01545-7804

Mailing address

602 Avalon Way
Shrewsbury, MA 01545-7804

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1395964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398816000000",
    "number": "1851718779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 AVALON WAY",
            "city": "SHREWSBURY",
            "state": "MA",
            "postal_code": "015457804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 AVALON WAY",
            "city": "SHREWSBURY",
            "state": "MA",
            "postal_code": "015457804",
            "telephone_number": "917-319-9180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE HEALTH ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-28",
        "last_updated": "2014-04-30",
        "status": "A",
        "authorized_official_last_name": "MAMIDALA",
        "authorized_official_first_name": "SURESH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-319-9180",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "241829",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "240724",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shrewsbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2014; 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.