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MUKUNDA MEDICAL GROUP LLC
NPI 1578267647
Internal Medicine in Mayfield Village, OH

Active since March 30, 2023CLIA Certified · 2 labs
6559 WILSON MILLS RD STE 106, MAYFIELD VILLAGE, OH 44143(855) 449-1540(440) 672-5068 Get Directions Write a Review

NPPES record last updated: November 21, 2024. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Nov 21, 2024, May 9, 2024, Nov 14, 2023 and 1 more (4 updates tracked since 2023).

About Mukunda Medical Group Llc NPPES

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

MUKUNDA MEDICAL GROUP LLC (NPI 1578267647) is a healthcare organization registered as an internal medicine in Mayfield Village, Ohio and active in the NPI registry since March 2023. The organization holds 2 active CLIA laboratory certificates and lists Beejadi N Mukunda, President, as its authorized official.

NPPES Registry Identity

NPI1578267647
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameMUKUNDA MEDICAL GROUP LLC
Location Address6559 WILSON MILLS RD STE 106Mayfield Village, OH 44143-3433
Mailing AddressPo Box 952041Cleveland, OH 44193-0051 · (855) 449-1540 · Fax (440) 672-5068
Phone(855) 449-1540
Fax(440) 672-5068
Organization SubpartNo
Authorized OfficialBeejadi N MukundaPresident · (855) 449-1540
Enumeration DateMarch 30, 2023
Last NPPES UpdateNovember 21, 20244 updates tracked since enumeration
NPPES CertifiedNovember 21, 2024
✔ NPI 1578267647 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
6559 WILSON MILLS RD STE 106, Mayfield Village, OH 44143
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mukunda Medical Group Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Mukunda Medical Group LLC, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 5 within 10 miles. They are listed nearest first.

Clinicians, nearest first (5)

Abby Dennison
Nurse Practitioner
NPI 1700601937
6559 WILSON MILLS RD STE 106
Mayfield Village, OH 44143
(855) 449-1540
✔ PECOS✔ Accepts MedicareSame address
Katy Rieker, CNP
Nurse Practitioner
NPI 1306719570
6559 WILSON MILLS RD STE 106A
Mayfield Village, OH 44143
(855) 449-1540
✔ PECOS✔ Accepts MedicareSame address
Lyndsey Decesare
Nurse Practitioner
NPI 1912540543
6559 WILSON MILLS RD STE 106A
Mayfield Village, OH 44143
(855) 449-1540
✔ PECOS✔ Accepts MedicareSame address
Beejadi Mukunda, M.D.
Internal Medicine
NPI 1225087208
6559 WILSON MILLS RD STE 106A
Mayfield Village, OH 44143
(855) 449-1540
✔ PECOS✔ Accepts MedicareSame address
Kylie Walters, CNP
Nurse Practitioner
NPI 1528841889
9500 EUCLID AVE # S2
Cleveland, OH 44195
(216) 444-8265
✔ PECOS✔ Accepts Medicare9.7 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 36D2280502

Mukunda Medical Group, LLC · Mayfield Village, OH
Active · expires Apr 19, 2027
CLIA Number36D2280502
Laboratory TypePhysician Office
Certificate Effective DateApril 20, 2025
Certificate Expiration DateApril 19, 2027
Laboratory DirectorBeejadi N. Mukunda
Laboratory Phone(855) 449-1540
Laboratory LocationMukunda Medical Group, LLC6559 Wilson Mills Rd Ste 106, Mayfield Village, OH 44143
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 36D2343564

Mukunda Medical Group LLC · Mentor, OH
Active · expires May 7, 2028
CLIA Number36D2343564
Laboratory TypePhysician Office
Certificate Effective DateMay 8, 2026
Certificate Expiration DateMay 7, 2028
Laboratory DirectorBeejadi N. Mukunda
Laboratory Phone(855) 449-1540
Laboratory LocationMukunda Medical Group LLC7496 Mentor Ave, Mentor, OH 44060
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Mukunda Medical Group LLC's NPI number?

The NPI number for Mukunda Medical Group LLC is 1578267647. It was assigned to this organization in the NPPES registry on March 30, 2023.

Where is Mukunda Medical Group LLC located?

Mukunda Medical Group LLC is located at 6559 Wilson Mills Rd Ste 106, Mayfield Village, OH 44143. The listed phone number is (855) 449-1540.

What is Mukunda Medical Group LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Mukunda Medical Group LLC enrolled in Medicare?

Yes. Mukunda Medical Group LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mukunda Medical Group LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Mukunda Medical Group LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (4) and Internal Medicine (1). Of these, 4 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Mukunda Medical Group LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Mukunda Medical Group LLC accept?

Health plans from AmeriHealth Caritas Next and Anthem Blue Cross and Blue Shield list Mukunda Medical Group LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mukunda Medical Group LLC was last updated on November 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.