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DR. JALAJA GUNDRATHI M.D
NPI 1699126771
Pediatrics in Mason City, IA

Active since June 29, 2016PECOS Enrolled
910 N EISENHOWER, MASON CITY, IA 50401(641) 428-5437(641) 428-5800 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 7, 2023, Apr 20, 2021, Aug 3, 2020 and 2 more (5 updates tracked since 2016).

About Dr. Jalaja Gundrathi M.d NPPES

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

DR. JALAJA GUNDRATHI M.D (NPI 1699126771) is an individual pediatrics provider in Mason City, Iowa, licensed in Iowa (MD-45745) and active in the NPI registry since June 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1699126771
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameDR. JALAJA GUNDRATHICredential: M.D
Location Address910 N EISENHOWERMason City, IA 50401-1525
Mailing Address621 S Illinois Ave, Suite 103Mason City, IA 50401-5489 · (641) 428-5437 · Fax (641) 428-5437
Phone(641) 428-5437
Fax(641) 428-5800
Sole ProprietorYes
Enumeration DateJune 29, 2016
Last NPPES UpdateMarch 7, 20235 updates tracked since enumeration
NPPES CertifiedMarch 7, 2023
✔ NPI 1699126771 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in IA · MD-45745
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Also ListedGeneral Acute Care Hospital · ChildrenTaxonomy 282NC2000X
910 N EISENHOWER, Mason City, IA 50401
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health, Blue Cross Blue Shield of Arizona and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jalaja Gundrathi M.d 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.

Medicare Billing Reassignments

2

Medicare enrollment records show Jalaja Gundrathi reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

North Iowa Mercy Clinics
Same address
Nephrology
910 N EISENHOWER AVE
Mason City, IA 50401
  • Reassigned Medicare billing, Iowa enrollment
  • 420 clinicians in this Medicare group
NPI 1003082736 (641) 428-7799
Banner Childrens Banner Health Clinic LLC
1,216 mi
Primary Care
2901 N CENTRAL AVE STE 160
Phoenix, AZ 85012
  • Reassigned Medicare billing, Arizona enrollment
  • 57 clinicians in this Medicare group
NPI 1285278077 (602) 747-4000

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 50401 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.84 typical visit price
range $52.96 – $161.40
Typical copayment $20.46 (range $13.24 – $40.35)
Most-billed visit code 99203
Established Patient
$94.05 typical visit price
range $16.91 – $131.98
Typical copayment $23.51 (range $4.22 – $32.99)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ADEL F MAKAR MD
Pediatrics (Adolescent Medicine)
910 N EISENHOWER, SUITE PEDS
MASON CITY, IA 50401
Cerro Gordo County (641) 422-5437
DR. JAFFAR A SHAIKH MD
Pediatrics (Adolescent Medicine)
910 N EISENHOWER, SUITE PEDS
MASON CITY, IA 50401
Cerro Gordo County (641) 422-5437
DR. TAMI R WIEGMANN MD
Pediatrics (Adolescent Medicine)
910 N EISENHOWER, SUITE PEDS
MASON CITY, IA 50401
Cerro Gordo County (641) 422-5437

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 Jalaja Gundrathi's NPI number?

The NPI number for Jalaja Gundrathi is 1699126771. It was assigned to this individual provider in the NPPES registry on June 29, 2016.

Where is Jalaja Gundrathi located?

Jalaja Gundrathi practices at 910 N Eisenhower, Mason City, IA 50401. The listed phone number is (641) 428-5437.

What is Jalaja Gundrathi's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Jalaja Gundrathi enrolled in Medicare?

Yes. Jalaja Gundrathi is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Jalaja Gundrathi's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jalaja Gundrathi reassigns Medicare benefits to 2 organizations: North Iowa Mercy Clinics (Mason City, IA) and Banner Childrens Banner Health Clinic LLC (Phoenix, AZ). Each 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 Jalaja Gundrathi's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jalaja Gundrathi accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona, Oscar Health and Oscar Health Plan, Inc. and 2 other insurers list Jalaja Gundrathi 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 Jalaja Gundrathi was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.