Active NPI
Gopi Rana Rana Mukkavilli, MD
- Internal Medicine Physician
- Trenton, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 25MA07228100
- Practice address
- 601 Hamilton Ave
Trenton, NJ 08629-1986 - Phone
- (609) 599-5050
- NPI assigned
- Jan 9, 2007
- Last updated
- Jan 17, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 179769 | NY | |
| Internal Medicine Physician | 207R00000X | 25MA07228100 | NJ | Primary |
Addresses
Primary practice location
601 Hamilton Ave
Trenton, NJ 08629-1986
Mailing address
601 Hamilton Ave.
Trenton, NJ 08629-1986
Phone (609) 599-5050
Other practice location 1
750 Brunswick Ave
Trenton, NJ 08638
Phone (609) 394-6000
Other practice location 2
1 Capital Way
Pennington, NJ 08534
Phone (609) 303-4000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 179769 | NY | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Capital Health Multispecialty Group | Internal Medicine | Current | Accepting new patients |
| The Osborn Family Health Center, Inc. | Current | Accepting new patients | |
| The Osborn Family Health Center, Inc. | Current | Accepting new patients |
Locations
1601 Haddon Ave
Camden, NJ 08103
Phone (856) 757-3700
3131 Princeton Pike
Bldg 5
Lawrenceville, NJ 08648
Phone (609) 844-9661
1 Capital Way
Pennington, NJ 08534
Phone (609) 303-4000
601 Hamilton Ave
Trenton, NJ 08629
Phone (609) 599-5000
750 Brunswick Ave
Trenton, NJ 08638
Phone (609) 394-6000
Interoperability endpoints
- gopi.rana.mukkavilli.1@12833.direct.athenahealth.com
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72983
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Camden, NJ
- NPI 1528444254
-
- Federally Qualified Health Center (FQHC)
- Camden, NJ
- NPI 1730695305
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673913600000",
"number": "1962551242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 HAMILTON AVE.",
"city": "TRENTON",
"state": "NJ",
"postal_code": "086291986",
"telephone_number": "609-599-5050",
"fax_number": "609-599-4318"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 HAMILTON AVE",
"city": "TRENTON",
"state": "NJ",
"postal_code": "086291986",
"telephone_number": "609-599-5050"
}
],
"practiceLocations": [
{
"address_1": "750 Brunswick Ave",
"address_purpose": "LOCATION",
"city": "Trenton",
"state": "NJ",
"postal_code": "08638",
"country_code": "US",
"telephone_number": "609-394-6000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Capital Way",
"address_purpose": "LOCATION",
"city": "Pennington",
"state": "NJ",
"postal_code": "08534",
"country_code": "US",
"telephone_number": "609-303-4000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RANA MUKKAVILLI",
"first_name": "GOPI",
"middle_name": "RANA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-09",
"last_updated": "2023-01-17",
"certification_date": "2023-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "179769",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NJ",
"license": "25MA07228100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Trenton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; 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.