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SANJAY MUDIGONDA M.D. NPI 1942277983


NPI Information

NPI: 1942277983
Provider Name: SANJAY MUDIGONDA, M.D.
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

PECOS Registration: Yes

Address:
2014 WASHINGTON STREET
NEWTON, MA
ZIP 02462
Phone: (617) 243-6162
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Sanjay Mudigonda, M.D. is a diagnostic radiology radiology in Newton, MA with 25 years of experience. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Sanjay Mudigonda, M.D. NPI is 1942277983. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE
Graduation Year:1999

The provider's business location address is:

2014 WASHINGTON STREET
NEWTON, MA
ZIP 02462
Phone: (617) 243-6162
Fax: (207) 347-7401

The NPI 1942277983 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/8/2006 and was last updated on 9/27/2011.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0202XRadiologyDiagnostic Radiology221962MASSACHUSETTSYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1I08976MEDICARE UPIN
2A36931MEDICARE ID-TYPE UNSPECIFIEDMASSACHUSETTS
32066262MEDICAIDMASSACHUSETTS
4467604OTHERMASSACHUSETTSTUFTS HEALTH CARE
5J28221OTHERMASSACHUSETTSBLUE CROSS BLUE SHIELD
6A36931MEDICARE PIN

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: 5/5/2024
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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.

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