DR. SUMANTH MULAMALLA MD NPI 1003019647
Internal Medicine (Nephrology) in Dyer, IN
NPI Profile for DR. SUMANTH MULAMALLA MD
Sumanth Mulamalla is an internal medicine provider established in Dyer, Indiana and his medical specialization is internal medicine (nephrology) with more than 20 years of experience. He graduated from Eastern Virginia Medical School in 2003. The NPI number of Sumanth Mulamalla is 1003019647 and was assigned on June 2007. The practitioner's primary taxonomy code is 207RN0300X with license number 01065980A (IN). The provider is registered as an individual and his NPI record was last updated 6 years ago.
An internist like Dr. Sumanth Mulamalla Md is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Sumanth Mulamalla is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Sumanth Mulamalla is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with Roane Medical Center, Great Plains Regional Medical Center, Cumberland Medical Center and Mary Lanning Healthcare.
| NPI | 1003019647 |
| Provider Name | DR. SUMANTH MULAMALLA MD |
| Provider Location Address | 15900 W 101ST AVE DYER, IN 46311 |
| Provider Mailing Address | 210 S DESPLAINES ST CHICAGO, IL 60661 |
| Gender | Male |
| NPI Entity Type | Individual |
| Medical School Name | EASTERN VIRGINIA MEDICAL SCHOOL |
| Graduation Year | 2003 |
| Is Sole Proprietor? | No |
| Is Organization Subpart? | N/A |
| Enumeration Date | 06-11-2007 |
| Last Update Date | 04-21-2016 |
Primary Taxonomy
| Taxonomy Code | 207RN0300X |
| Classification | Internal Medicine |
| Type | Allopathic & Osteopathic Physicians |
| Specialization | Nephrology |
| License No. | 01065980A |
| License State | IN |
| Taxonomy Description | An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
Business Address
DR. SUMANTH MULAMALLA MD
15900 W 101ST AVE
DYER, IN
ZIP 46311
Phone: (219) 365-6333
Fax: (219) 365-8291
Mailing Address
DR. SUMANTH MULAMALLA MD
210 S DESPLAINES ST
CHICAGO, IL
ZIP 60661
Phone: (312) 654-2700
Fax: (312) 654-9930
PECOS Enrollment and Medicare Participation
What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
| Registered in PECOS? | Yes |
| PECOS PAC ID | 8022160878 |
| PECOS Enrollment ID | I20191218000565, I20210524002077 |
| Accepts Medicare Assignment? | Yes "What does it mean "accepts medicare assignment"? When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts. A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer. |
| Eligible order / refer Part B Clinical Laboratory and Imaging | Yes |
| Eligible order / refer Durable Medical Equipment | Yes |
| Eligible order / refer Home Health Agency (HHA) | Yes |
| Eligible order / refer Power Mobility Devices | Yes |
Clinician Utilization
The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.
- 119Dialysis services (4 or more physician visits per month), patient 20 years of age and older (HCPCS:90960)
- 77Hemodialysis procedure with one physician evaluation (HCPCS:90935)
- 28Dialysis services (2-3 physician visits per month), patient 20 years of age and older (HCPCS:90961)
Hospital Affiliations
Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Sumanth Mulamalla is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | CMS Certification Number (CCN) | Overall Rating |
|---|---|---|---|---|---|
| ROANE MEDICAL CENTER | 8045 ROANE MEDICAL CENTER DRIVE HARRIMAN, TN 37748 | (865) 316-1000 | Acute Care Hospitals | 440031 | |
| GREAT PLAINS REGIONAL MEDICAL CENTER | 1801 WEST 3RD STREET ELK CITY, OK 73644 | (580) 225-2511 | Acute Care Hospitals | 370019 | |
| CUMBERLAND MEDICAL CENTER | 421 S MAIN ST CROSSVILLE, TN 38555 | (931) 484-9511 | Acute Care Hospitals | 440009 | |
| MARY LANNING HEALTHCARE | 715 N ST JOSEPH AVE HASTINGS, NE 68901 | (402) 461-5108 | Acute Care Hospitals | 280032 |
Additional Identifiers
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 201121060A | MEDICAID (05) | IN | |
| F400289465 | OTHER (01) | IL | IL MEDICARE PTAN |
NPI Validation Check Digit Calculation
The following table explains step by step the NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 0 | 3 | 0 | 1 | 9 | 6 | 4 | 7 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 0 | 3 | 0 | 1 | 18 | 6 | 8 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 0 + 3 + 0 + 1 + 1 + 8 + 6 + 8 + 24 = 53 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 53 = 7 | 7 | ||||||||
The NPI number 1003019647 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the same location
The following 15 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1699720144 | GARY A MARCOTTE DO Individual | Family Medicine | 15900 W 101ST AVE DYER, IN 46311 (219) 365-6333 |
| 1508399379 | ABIGAIL REARDON FNP Individual | Nurse Practitioner (Family) | 15900 W 101ST AVE DYER, IN 46311 (219) 365-6333 |
| 1104454065 | CHRISTY LYNN MARCOTTE PHARMD Individual | Pharmacist | 15900 W 101ST AVE DYER, IN 46311 (219) 365-6333 |
| 1669424768 | MARCOTTE MEDICAL GROUP, PC Organization | Family Medicine | 15900 W 101ST AVE DYER, IN 46311 (219) 365-6333 |
| 1619216264 | HEATHER ANN VAN LATEN FNP-BC Individual | Nurse Practitioner (Family) | 15900 W 101ST AVE DYER, IN 46311 (219) 365-6333 |
| 1073587507 | ROBERT KOVACHEVICH DO Individual | Family Medicine | 15900 W 101ST AVE DYER, IN 46311 (219) 365-6333 |
| 1669447900 | JODI BULT N.P. Individual | Nurse Practitioner (Adult Health) | 15900 W 101ST AVE DYER, IN 46311 (219) 365-6333 |
| 1619945797 | SANDRA B MARCOTTE DO Individual | Family Medicine | 15900 W 101ST AVE DYER, IN 46311 (219) 365-6333 |
| 1104879477 | CHRISTINE M MARCOTTE DO Individual | Family Medicine | 15900 W 101ST AVE DYER, IN 46311 (219) 365-6333 |
| 1649224734 | TREVOR J MARCOTTE DO Individual | Family Medicine | 15900 W 101ST AVE DYER, IN 46311 (219) 365-6333 |
| 1497107114 | KATRINA SCHABACKER FNP-BC Individual | Nurse Practitioner (Family) | 15900 W 101ST AVE DYER, IN 46311 (219) 365-6333 |
| 1487135034 | AMIE SWARDSON BARRY FNP-BC Individual | Nurse Practitioner (Family) | 15900 W 101ST AVE DYER, IN 46311 (219) 365-6333 |
| 1679110266 | EMILY NICOLE MRZLOCK APN Individual | Nurse Practitioner (Family) | 15900 W 101ST AVE DYER, IN 46311 (219) 365-6333 |
| 1467118034 | REBECCA TORTOLANO FNP Individual | Nurse Practitioner (Family) | 15900 W 101ST AVE DYER, IN 46311 (219) 365-6333 |
| 1578221636 | DAWN LITTLE FNP Individual | Nurse Practitioner (Family) | 15900 W 101ST AVE DYER, IN 46311 (219) 365-6333 |
NPI Footnotes
What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
Entity Type Code
Dr. Sumanth Mulamalla Md is registered as an entity type code: 1. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:
- 1 = Person: individual human being who furnishes health care.
- 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date
The date that a NPI record was last updated or changed.
Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.