Individual provider Active NPI

Gopi Rana Rana Mukkavilli, MD

  • Internal Medicine Physician
  • Trenton, NJ
National Provider Identifier
1962551242
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA07228100 Issued in NJ
Practice address
601 Hamilton Ave
Trenton, NJ 08629-1986
Phone
(609) 599-5050
NPI assigned
Jan 9, 2007
Last updated
Jan 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081104000039 NJ Practitioner - Internal Medicine 3072672211 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
179769NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Health Multispecialty Group Internal Medicine CurrentSince Dec 21, 2022 Accepting new patients
The Osborn Family Health Center, Inc. CurrentSince Aug 12, 2024 Accepting new patients
The Osborn Family Health Center, Inc. CurrentSince Aug 12, 2024 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

  • Direct secure messaging: gopi.rana.mukkavilli.1@12833.direct.athenahealth.com
  • FHIR API: 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.

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

Verify at the official NPI Registry.