Mamatha Yeturu, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD438489 Issued in PA

Practice address

1991 Sproul Rd
Suite 625
Broomall, PA 19008-3512

Phone

(484) 421-1669

Fax

(484) 565-8556

NPI assigned

Apr 25, 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

Medicare fee-for-service enrollment

Enrolled in PA

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, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Main Line Hospital Lankenau Hospital, Wynnewood, PA, CCN 390195

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643
  Medicare reassignment Care Compare group NPD

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

• Main Line Hospitals, Inc.

  • General Acute Care Hospital
  • Wynnewood, PA
  • NPI 1245335629
  Care Compare affiliation

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420588800000",
    "number": "1982823985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1991 SPROUL RD",
            "address_2": "SUITE 625",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083512",
            "telephone_number": "484-421-1669",
            "fax_number": "484-565-8556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 SPROUL RD",
            "address_2": "SUITE 625",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083512",
            "telephone_number": "484-421-1669",
            "fax_number": "484-565-8556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YETURU",
        "first_name": "MAMATHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2015-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD438489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Rose Witte
• Carolyn Marie Witzke, PA-C
• Daniel L Wolk, M.D.
• Wayne Wrolstad
• Lynn Yang, MD
• Alison Yez, CRNP
• James T Young, DPT
• Jill Jani Yousif, COTA/L
• Christine M Zabel, D.O.
• Stephanie D Zadroga, CRNP

• Family Medicine Physician in Broomall, PA
• Providers in Broomall, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2015; 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.