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DR. LATA TAVANANDI MUNDKUR M.D. NPI 1487645248


NPI Information

NPI: 1487645248
Provider Name: DR. LATA TAVANANDI MUNDKUR, M.D.
Classification: Internal Medicine - 207R00000X
Entity Type: Individual

CLIA Number: 22D0943104

Address:
817 MERRIMACK ST
SECOND FLOOR
LOWELL, MA
ZIP 01854
Phone: (978) 452-0672
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DR. Lata Tavanandi Mundkur, M.D. is an internal medicine in Lowell, MA. The provider is 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. DR. Lata Tavanandi Mundkur, M.D. NPI is 1487645248. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

817 MERRIMACK ST
SECOND FLOOR
LOWELL, MA
ZIP 01854-571
Phone: (978) 452-0672

The CLIA number assigned to this NPI record is 22D0943104 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/2/2005 and was last updated on 8/9/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine58514MASSACHUSETTSNo
2207R00000XInternal Medicine58514MASSACHUSETTSYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1J06028OTHERMASSACHUSETTSBLUE CROSS BLUE SHIELD
2109517OTHERMASSACHUSETTSGREAT-WEST (ONE HEALTH)
365438OTHERMASSACHUSETTSHARVARD PILGRIM
43015599MEDICAIDMASSACHUSETTS
5043117888OTHERMASSACHUSETTSFEDERAL TAX ID
6058514OTHERMASSACHUSETTSTUFTS HEALTH PLAN
733756OTHERMASSACHUSETTSUNICARE - HEALTHY START
804-3117888OTHERMASSACHUSETTSGREAT-WEST
904-3117888OTHERMASSACHUSETTSMULTIPLAN
1004-3117888OTHERMASSACHUSETTSCOVENTRY
111487645248OTHERMASSACHUSETTSCELTICARE
120017292OTHERMASSACHUSETTSNEIGHBORHOOD HEALTH PLAN
130401929OTHERMASSACHUSETTSUNITED HEALTH CARE
14A58685MEDICARE UPINMASSACHUSETTS
15970357OTHERMASSACHUSETTSNETWORK HEALTH
164328196OTHERMASSACHUSETTSAETNA
17J06028MEDICARE ID-TYPE UNSPECIFIEDMASSACHUSETTS
18$$$$$$$$$OTHERMASSACHUSETTSGIC
1904-3117888OTHERMASSACHUSETTSBEECH STREET
20043117888OTHERMASSACHUSETTSTRICARE-NORTH
210466975OTHERMASSACHUSETTSAETNA US HEALTHCARE
2222D0943104OTHERMASSACHUSETTSCLIA
232449768OTHERMASSACHUSETTSCIGNA
2445819OTHERMASSACHUSETTSFALLON COMMUNITY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.