Pallavi Reddy Koppolu, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

R71692 Issued in AZ

Practice address

2800 E Ajo Way
Tucson, AZ 85713-6204

Phone

(520) 874-4502

Fax

(520) 874-4510

NPI assigned

Jun 29, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Pallavi Reddy Munagala Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334102400000",
    "number": "1952508301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 E AJO WAY",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857136204",
            "telephone_number": "520-874-4502",
            "fax_number": "520-874-4510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E AJO WAY",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857136204",
            "telephone_number": "520-874-4502",
            "fax_number": "520-874-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPPOLU",
        "first_name": "PALLAVI",
        "middle_name": "REDDY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-29",
        "last_updated": "2012-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "R71692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PALLAVI",
            "last_name": "MUNAGALA",
            "middle_name": "REDDY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kerry Kopecky, FNP
• Brian J Kopp, PHARM.D.
• Joseph Kopp
• Lisa Kopp
• Matthew Koppinger, OD
• Carol Kopsco, L.C.S.W.
• Hannah Korah
• Kevin Alexander Koralewski, O.D.
• Sophia Korb
• Kords Metro Service Inc

• Internal Medicine Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.