Deva Prakash Gundupalli, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD28133 Issued in ME

Practice address

175 W Broadway
Lincoln, ME 04457-4000

Phone

(207) 794-6700

NPI assigned

May 10, 2024

Sex

Male

Sole proprietor

No

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 ME

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

Family Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Health Access Network IncGroup PAC ID 2769393180, 24 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Penobscot Valley Hospital Hospital, Lincoln, ME, CCN 201303
• Northern Light Mercy Hospital Hospital, Portland, ME, CCN 200008
• Northern Light Eastern Maine Medical Center Hospital, Bangor, ME, CCN 200033
• Houlton Regional Hospital Hospital, Houlton, ME, CCN 201308

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DBFIBD

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.

• Health Access Network, Inc

  • Federally Qualified Health Center (FQHC)
  • Lincoln, ME
  • NPI 1467468215

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Health Access Network, Inc.

  • Federally Qualified Health Center (FQHC)
  • Lincoln, ME
  • NPI 1295993616
  NPD
• Health Access Network, Inc.

  • Federally Qualified Health Center (FQHC)
  • Millinocket, ME
  • NPI 1760640189
  NPD

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

• Eastern Maine Medical Center

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1790789147
  Care Compare affiliation
• Houlton Regional Hospital

  • Critical Access Hospital
  • Houlton, ME
  • NPI 1508823741
  Care Compare affiliation
• Mercy Hospital

  • General Acute Care Hospital
  • Portland, ME
  • NPI 1427313048
  Care Compare affiliation
• Mercy Hospital

  • General Acute Care Hospital
  • Portland, ME
  • NPI 1629078712
  Care Compare affiliation
• Penobscot Valley Hospital

  • Critical Access Hospital
  • Lincoln, ME
  • NPI 1093716086
  Care Compare affiliation

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

{
    "created_epoch": "1715299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1982452207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 W BROADWAY",
            "city": "LINCOLN",
            "state": "ME",
            "postal_code": "044574000",
            "telephone_number": "207-794-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 W BROADWAY",
            "city": "LINCOLN",
            "state": "ME",
            "postal_code": "044574000",
            "telephone_number": "207-794-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDUPALLI",
        "first_name": "DEVA",
        "middle_name": "PRAKASH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-10",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "MD28133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Arthur Goolsby, LCSW
• Mary Catherine Goolsby, LCSW
• Sheri Grant, MSOTR/L
• Greater Lincoln Sleep Center
• Gregory M Farrell OD
• Hannaford Bros Co LLC
• Madalene Morgan Hartford-Stewart, LCPC, CADC
• Jennifer Harvey, M.A., CCC-SLP
• William E Head, PA-C.
• Health Access Network Inc

• Family Medicine Physician in Lincoln, ME
• Providers in Lincoln, ME by specialty
• Family Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; 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.