Individual provider Active NPI

Simhachalam Gurugubelli, MD

  • Student in an Organized Health Care Education/Training Program
  • Aurora, CO
National Provider Identifier
1891281820
Registry record updated Aug 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
TL.0011109 Issued in CO
Practice address
1635 Aurora CT
Aurora, CO 80045-2517
Phone
(720) 848-7700
NPI assigned
Jul 2, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TL.0011109 CO Primary

Addresses

Primary practice location

1635 Aurora CT
Aurora, CO 80045-2517

Mailing address

1775 Aurora CT
Aurora, CO 80045-2506
Phone (303) 724-8695

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210915003278 MS Practitioner - Internal Medicine 4587913827 Reassigns benefits to 1 organization
I20250129001625 IN Practitioner - Internal Medicine 4587913827 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Parkview Health System IncGroup PAC ID 2163336967, 1,350 clinicians

Practice addresses (Care Compare)

11109 Parkview Plaza Dr
Fort Wayne, IN 46845-1701
Phone (260) 266-2020

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301116161MIMDInternal Medicine Physician
29092MSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Health System Inc Internal Medicine Current Accepting new patients
Memorial Hospital at Gulfport Current Accepting new patients
Memorial Hospital at Gulfport Internal Medicine CurrentSince Jul 1, 2021 Accepting new patients
Parkview Health System, Inc. Internal Medicine CurrentSince Nov 28, 2024 Accepting new patients
Memorial Hospital at Gulfport CurrentSince Jul 1, 2021 Accepting new patients

Locations

11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012

11109 Parkview Plaza Dr
Fort Wayne, IN 46845
Phone (260) 266-2020

2200 Randallia Dr
Fort Wayne, IN 46805
Phone (260) 373-4000

240 S Jefferson St
Ste B
Huntington, IN 46750
Phone (219) 259-0000

512 Professional Way
Kendallville, IN 46755
Phone (260) 347-8556

300 Drinkwater Rd
Bay St Louis, MS 39520
Phone (228) 255-6868

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

Interoperability endpoints

  • Direct secure messaging: sgurugubelli@direct.mhg.com
  • Direct secure messaging: sgurugubelli654092@direct.parkviewexchange.com

Organizations & group practices 6

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 6

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": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1891281820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 AURORA CT",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452506",
            "telephone_number": "303-724-8695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 AURORA CT",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452517",
            "telephone_number": "720-848-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURUGUBELLI",
        "first_name": "SIMHACHALAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-02",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CO",
            "license": "TL.0011109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.