Phani Kishore Molakatalla, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

261931 Issued in MA

Practice address

250 Green St
Suite 209
Gardner, MA 01440-1396

Phone

(978) 669-5522

Fax

(978) 632-0516

NPI assigned

Jun 25, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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 1

Specialty

Gastroenterology

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Heywood Medical Group Inc.Group PAC ID 6901882836, 111 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Heywood Hospital - Hospital, Gardner, MA, CCN 220095
• Athol Memorial Hospital Hospital, Athol, MA, CCN 221303
• Umass Memorial Medical Center/University Campus Hospital, Worcester, MA, CCN 220163

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as apm

Quality

82.98

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: phani.molakatalla.1@192.direct.athenahealth.com

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.

• Heywood Medical Group Inc.

  • General Practice Physician
  • Gardner, MA
  • NPI 1699762286

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Athol Memorial Hospital Incorporated

  • Critical Access Hospital
  • Athol, MA
  • NPI 1336120047
  Medicare reassignment NPD
• Henry Heywood Memorial Hospital

  • General Acute Care Hospital
  • Gardner, MA
  • NPI 1205823879
  Medicare reassignment NPD
• Henry Heywood Memorial Hospital

  • Psychiatric Hospital Unit
  • Gardner, MA
  • NPI 1457685299
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Athol Memorial Hospital Incorporated

  • Critical Access Hospital
  • Athol, MA
  • NPI 1336120047
  Care Compare affiliation
• Henry Heywood Memorial Hospital

  • General Acute Care Hospital
  • Gardner, MA
  • NPI 1205823879
  Care Compare affiliation
• Heywood Medical Group Inc.

  • General Practice Physician
  • Gardner, MA
  • NPI 1699762286

  Hospital

  Care Compare affiliation
• Umass Memorial Medical Center, Inc.

  • General Acute Care Hospital
  • Worcester, MA
  • NPI 1831151455
  Care Compare affiliation

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436227200000",
    "number": "1861620007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 GREEN ST",
            "address_2": "SUITE 209",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014401396",
            "telephone_number": "978-669-5522",
            "fax_number": "978-632-0516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 GREEN ST",
            "address_2": "SUITE 209",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014401396",
            "telephone_number": "978-669-5522",
            "fax_number": "978-632-0516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLAKATALLA",
        "first_name": "PHANI",
        "middle_name": "KISHORE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-25",
        "last_updated": "2015-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD447302",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT194411",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MA",
            "license": "261931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Bryan Miller III, MD
• Aubrey Milligan, BS
• Mind Over Matter, LLC
• Cynthia Ann Minezzi, OTR
• Adrienne Castillo Mitchell
• Megan Moncecchi, PHARMD
• Colby L Monette, BA
• Elizabeth Irene Moody
• Bridget Elizabeth Moore
• Vera Lucia Moraes, PT

• Gastroenterology Physician in Gardner, MA
• Providers in Gardner, MA by specialty
• Gastroenterology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.