Individual provider Active NPI

Gowri Kularatna, M.D.

  • Internal Medicine Physician
  • Waldorf, MD
National Provider Identifier
1861682957
Registry record updated Mar 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
233288 Issued in MA
Practice address
12070 Old Line Ctr
Suite 200
Waldorf, MD 20602-2513
Phone
(301) 645-8035
NPI assigned
Jul 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2012

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 233288 MA Primary

Addresses

Primary practice location

12070 Old Line Ctr
Suite 200
Waldorf, MD 20602-2513

Mailing address

12070 Old Line Ctr
Suite 200
Waldorf, MD 20602-2513

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20120309000549 MD Practitioner - GastroenterologyPractitioner - Internal Medicine 4587751250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
University of Maryland School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3510 Old Washington Rd
Suite 201
Waldorf, MD 20602-3235
Phone (301) 645-8035

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy121
Upper gastrointestinal (GI) endoscopy for acid reflux102

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Waldorf Anesthesia Services LLC PastSince May 1, 2016 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.

Hospital & facility affiliations 4

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": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330992000000",
    "number": "1861682957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12070 OLD LINE CTR",
            "address_2": "SUITE 200",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12070 OLD LINE CTR",
            "address_2": "SUITE 200",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022513",
            "telephone_number": "301-645-8035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULARATNA",
        "first_name": "GOWRI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-26",
        "last_updated": "2012-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "233288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

Verify at the official NPI Registry.