DR. AMRUTHA DENDULURI (MBBS, MPH) – Family Medicine Physician, NPI 1174290951

DR. AMRUTHA DENDULURI (MBBS, MPH) is a healthcare provider. based in Little rock, Arkansas. specializing in FAMILY PRACTICE. They hold the professional credentials MBBS, MPH. They hold a License No. 1020881 (MA). The NPI Number for DR. AMRUTHA DENDULURI (MBBS, MPH) is 1174290951

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
DR. AMRUTHA DENDULURI (MBBS, MPH)
NPI
1174290951
Phone
(501) 686-8820
Address
4301 W MARKHAM ST
Enumeration Date
27 August 2021
Last Update Date
1 November 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6174144465
Graduation Year
2019 (7 years ago)
PAC ID
0042609471
Group Practice PAC ID
0446154074
Professional Enrollment ID
I20241122002357
Address ID
MA021182908BO1XXXXPLXX500
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:4State licenses:1Digital endpointsOther names

1,499 FAMILY PRACTICE in AR

Provider Addresses for DR. AMRUTHA DENDULURI (MBBS, MPH)

  • 4301 W MARKHAM ST

    LITTLE ROCK, AR 722057101

    Phone: (501) 686-8820

    Type: Mailing

  • 4301 W MARKHAM ST # 530

    LITTLE ROCK, AR 722057199

    Phone: (501) 686-8820

    Type: Location

  • 637 WASHINGTON STREET

    DORCHESTER, MA 021243510

    Phone: (617) 825-9660

    Type: Location

  • 1 Boston Medical Ctr Pl Fl 5

    Boston, MA 021182908

    Phone: (617) 414-4465

    Type: Location

  • 960 MASSACHUSETTS AVE STE 2

    BOSTON, MA 021182690

    Phone: (617) 414-5404

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-11-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241122002357IFamily PracticeMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 72205)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0446154074View full group profile
NameSpecialtyState
-MA
Family PracticeMA
-MA
Sports Medicine, Family PracticeMA
Family PracticeMA
Family PracticeOH
Family PracticeMA
Family PracticeMA
Family PracticeMA
Nurse PractitionerMA

Reviews

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Frequently asked questions

What NPI should I save for DR. AMRUTHA DENDULURI (MBBS, MPH)?
Save NPI 1174290951 if you need a stable reference for DR. AMRUTHA DENDULURI (MBBS, MPH).
Does this profile mean DR. AMRUTHA DENDULURI (MBBS, MPH) is currently active?
Yes — DR. AMRUTHA DENDULURI (MBBS, MPH) appears active in the national provider directory.
What kind of provider is DR. AMRUTHA DENDULURI (MBBS, MPH)?
The page reflects Family Medicine Physician for DR. AMRUTHA DENDULURI (MBBS, MPH). Clinical services aligned with this taxonomy classification.
Does DR. AMRUTHA DENDULURI (MBBS, MPH) practice in Arkansas?
You will see Little Rock, Arkansas on file for DR. AMRUTHA DENDULURI (MBBS, MPH) alongside any extra practice locations.
How can I contact DR. AMRUTHA DENDULURI (MBBS, MPH)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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