Sri Divya Muppala, MD is a medicare enrolled "Internal Medicine" physician in Hebron, Kentucky. She graduated from medical school in 2004 and has 20 years of diverse experience with area of expertise as Internal Medicine. She is a member of the group practice Texas Health Physicians Group, Waterloo Park Inpatient Services Pllc and her current practice location is
2091 N Bend Rd, Hebron, Hebron, Kentucky. You can reach out to her office (for appointments etc.) via phone at
(859) 586-2200.
Sri Divya Muppala is licensed to practice in Kentucky (license number 44863) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1457557290.
Physician's Profile
| Full Name | Sri Divya Muppala |
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| Gender | Female |
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| Speciality | Internal Medicine |
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| Experience | 20 Years |
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| Location | 2091 N Bend Rd, Hebron, Kentucky |
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| Accepts Medicare Assignments | Yes. She 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:
- Sri Divya Muppala graduated from medical school in 2004
NPI Data:
- NPI Number: 1457557290
- Provider Enumeration Date: 06/26/2007
- Last Update Date: 09/13/2013
Medicare PECOS Information:
- PECOS PAC ID: 1052571460
- Enrollment ID: I20210105002175
Medical Identifiers
Medical identifiers for Sri Divya Muppala such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1457557290 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207R00000X | Internal Medicine | 2007013992 (Missouri) | Secondary |
| 207R00000X | Internal Medicine | 44863 (Kentucky) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Texas Health Physicians Group | 4385535954 | 1203 |
| Waterloo Park Inpatient Services Pllc | 4880820513 | 31 |
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. Sri Divya Muppala allows following entities to bill medicare on her behalf.
| Entity Name | Texas Health Physicians Group |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1174573596
PECOS PAC ID: 4385535954
Enrollment ID: O20040323000759 |
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| Entity Name | Waterloo Park Inpatient Services Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1013343912
PECOS PAC ID: 4880820513
Enrollment ID: O20131202000416 |
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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. Sri Divya Muppala 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 |
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Sri Divya Muppala, MD
2300 Chamber Center Dr, Suite 200,
Lakeside Park, KY 41017-1673
Ph: (859) 344-5555 | Sri Divya Muppala, MD
2091 N Bend Rd, Hebron,
Hebron, KY 41048-9691
Ph: (859) 586-2200 |
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