NPIMap

Individual provider Active NPI

Kavita Tumma, M.D.

  • Gastroenterology Physician
  • Port Huron, MI
National Provider Identifier
1871569095
Registry record updated Mar 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
4301060393 Issued in MI
Practice address
1231 Pine Grove Ave
Suite 2a
Port Huron, MI 48060-3500
Phone
(810) 982-8742
Fax
(810) 984-8291
NPI assigned
Feb 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 4301060393 MI Primary

Addresses

Primary practice location

1231 Pine Grove Ave
Suite 2a
Port Huron, MI 48060-3500

Mailing address

1231 Pine Grove Ave
Suite 2a
Port Huron, MI 48060-3500
Phone (810) 982-8742

Other identifiers 1

IdentifierTypeStateIssuer
1871569095MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100419000638 MI Practitioner - Gastroenterology 1153458484 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Healthcare Network PCGroup PAC ID 3476456252, 30 clinicians

Practice addresses (Care Compare)

1221 Pine Grove Ave
Port Huron, MI 48060-3511
Phone (810) 987-5000

1231 Pine Grove Ave
Suite 2a
Port Huron, MI 48060-3500
Phone (810) 982-8742

3050 Commerce Dr
Fort Gratiot, MI 48059-3819

3350 Gratiot Blvd
Marysville, MI 48040-2121
Phone (810) 364-4000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy380
Upper gastrointestinal (GI) endoscopy for acid reflux376

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hills & Dales General Hospital, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Hills & Dales General Hospital, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Marlette Regional Hospital CurrentSince Jan 1, 2025 Accepting new patients
Physician Healthcare Network, PC Gastroenterology CurrentSince May 1, 1999 Accepting new patients
Marlette Regional Hospital CurrentSince Jan 1, 2025 Accepting new patients
Deckerville Community Hospital, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Deckerville Community Hospital, Inc CurrentSince Jan 1, 2025 Accepting new patients

Locations

4675 Hill St
Cass City, MI 48726
Phone (989) 872-2121

3559 Pine St
Deckerville, MI 48427
Phone (810) 376-2835

2770 Main St
Marlette, MI 48453
Phone (989) 635-4000

3350 Gratiot Blvd
Marysville, MI 48040
Phone (810) 364-4000

1231 Pine Grove Ave
Ste 2A
Port Huron, MI 48060
Phone (810) 982-8742

Interoperability endpoints

  • Direct secure messaging: kavita.mahakalatumma.1@11357.direct.athenahealth.com

Organizations & group practices 10

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489363200000",
    "number": "1871569095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 PINE GROVE AVE",
            "address_2": "SUITE 2A",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603500",
            "telephone_number": "810-982-8742",
            "fax_number": "810-984-8291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 PINE GROVE AVE",
            "address_2": "SUITE 2A",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603500",
            "telephone_number": "810-982-8742",
            "fax_number": "810-984-8291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUMMA",
        "first_name": "KAVITA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-27",
        "last_updated": "2017-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "4301060393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871569095",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

Verify at the official NPI Registry.