Mamatha Moodalagiriaiah, M.D

Primary specialty

Obstetrics PhysicianTaxonomy code 207VX0000X

License

036-133305 Issued in IL

Practice address

1 Memorial Dr
Suite 300
Decatur, IL 62526-6303

Phone

(217) 872-2400

Fax

(217) 875-4680

NPI assigned

Jun 19, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Obstetrics/Gynecology

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Naperville Womens Health Care, PCGroup PAC ID 0042382194, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Edward Hospital Hospital, Naperville, IL, CCN 140231
• Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Naperville Womens Health Care, PC

  • Specialist
  • Naperville, IL
  • NPI 1063695237
  Medicare reassignment Care Compare group NPD
• HSHS Medical Group Inc

  • Rural Health Clinic/Center
  • Rushville, IL
  • NPI 1487719480
  NPD (past)

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

• Central Dupage Hospital Association

  • General Acute Care Hospital
  • Winfield, IL
  • NPI 1003864810
  Care Compare affiliation
• Central Dupage Hospital Association

  • Psychiatric Hospital Unit
  • Winfield, IL
  • NPI 1740230895
  Care Compare affiliation
• Edward Hospital

  • General Acute Care Hospital
  • Naperville, IL
  • NPI 1427069632
  Care Compare affiliation

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376006400000",
    "number": "1891058566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19266 TYRONE ST",
            "city": "HARPER WOODS",
            "state": "MI",
            "postal_code": "482252499",
            "telephone_number": "320-309-5583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEMORIAL DR",
            "address_2": "SUITE 300",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625266303",
            "telephone_number": "217-872-2400",
            "fax_number": "217-875-4680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODALAGIRIAIAH",
        "first_name": "MAMATHA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-19",
        "last_updated": "2013-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "IL",
            "license": "036-133305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Elizabeth Minton, LCPC
• Mission Care of Illinois, LLC
• Cassie Mitchell, LSW
• Jignesh Modi, M.D.
• Laura Moma, MA, CCC-SLP
• Karen Sue Moody, CRNA
• Alyssa G. Moomaw, MS, CCC-SLP/L
• Amanda Moore
• Elizabeth Moore, DMD
• Emma Moore

• Obstetrics Physician in Decatur, IL
• Providers in Decatur, IL by specialty
• Obstetrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2013; 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.