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MYTHILI JYOTHIRMAYI KANAGALA
NPI 1063208924
Student in an Organized Health Care Education/Training Program in Rockford, IL

Active since April 17, 2025PECOS Enrolled
MILESQUARE LP JOHNSON CENTER 1221 E. STATE ST., ROCKFORD, IL 61104(815) 972-1037 Get Directions Write a Review

NPPES record last updated: April 17, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mythili Jyothirmayi Kanagala NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MYTHILI JYOTHIRMAYI KANAGALA (NPI 1063208924) is an individual student in an organized health care education/training program in Rockford, Illinois and active in the NPI registry since April 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1063208924
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameMYTHILI JYOTHIRMAYI KANAGALA
Location AddressMILESQUARE LP JOHNSON CENTER 1221 E. STATE ST.Rockford, IL 61104
Mailing AddressMilesquare Lp Johnson Center 1221 E. State St.Rockford, IL 61104 · (815) 972-1037
Phone(815) 972-1037
Sole ProprietorNo
Enumeration DateApril 17, 2025
NPPES CertifiedApril 9, 2025
✔ NPI 1063208924 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
MILESQUARE LP JOHNSON CENTER 1221 E. STATE ST., Rockford, IL 61104
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mythili Jyothirmayi Kanagala is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mythili Kanagala's NPI number?

The NPI number for Mythili Kanagala is 1063208924. It was assigned to this individual provider in the NPPES registry on April 17, 2025.

Where is Mythili Kanagala located?

Mythili Kanagala practices at Milesquare LP Johnson Center 1221 E. State St., Rockford, IL 61104. The listed phone number is (815) 972-1037.

What is Mythili Kanagala's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Mythili Kanagala enrolled in Medicare?

Yes. Mythili Kanagala is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mythili Kanagala was last updated on April 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.