Dr Tejaswi Venkata Mudigonda, MD is a medicare enrolled "Dermatology - Mohs-micrographic Surgery" physician in Lebanon, Tennessee. He went to Vanderbilt University School Of Medicine and graduated in 2016 and has 9 years of diverse experience with area of expertise as Dermatology. He is a member of the group practice Csi Medical Group and his current practice location is
1424 W Baddour Pkwy Ste G, Lebanon, Tennessee. You can reach out to his office (for appointments etc.) via phone at
(615) 314-1699.
Dr Tejaswi Venkata Mudigonda is licensed to practice in Tennessee (license number 68967) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1891143277.
Physician's Profile
| Full Name | Dr Tejaswi Venkata Mudigonda |
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| Gender | Male |
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| Speciality | Dermatology |
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| Experience | 9 Years |
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| Location | 1424 W Baddour Pkwy Ste G, Lebanon, Tennessee |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Tejaswi Venkata Mudigonda attended and graduated from Vanderbilt University School Of Medicine in 2016
NPI Data:
- NPI Number: 1891143277
- Provider Enumeration Date: 05/26/2016
- Last Update Date: 03/12/2024
Medicare PECOS Information:
- PECOS PAC ID: 3072936707
- Enrollment ID: I20200714000184
Medical Identifiers
Medical identifiers for Dr Tejaswi Venkata Mudigonda such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1891143277 | NPI | - | NPPES |
| 207R00000X | Medicaid | OK | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207ND0900X | Dermatology - Dermatopathology | 68967 (Tennessee) | Secondary |
| 207NS0135X | Dermatology - Procedural Dermatology | 68967 (Tennessee) | Secondary |
| 207N00000X | Dermatology | 68967 (Tennessee) | Secondary |
| 207ND0101X | Dermatology - Mohs-micrographic Surgery | 68967 (Tennessee) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Csi Medical Group | 5890916845 | 100 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Tejaswi Venkata Mudigonda allows following entities to bill medicare on his behalf.
| Entity Name | Csi Medical Group |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1871909804
PECOS PAC ID: 5890916845
Enrollment ID: O20141016001930 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Tejaswi Venkata Mudigonda is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Tejaswi Venkata Mudigonda, MD
1424 W Baddour Pkwy Ste G,
Lebanon, TN 37087-2685
Ph: (615) 314-1699 | Dr Tejaswi Venkata Mudigonda, MD
1424 W Baddour Pkwy Ste G,
Lebanon, TN 37087-2685
Ph: (615) 314-1699 |
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