DR. SUMANTH MULAMALLA (MD) – Nephrology Physician, NPI 1003019647

DR. SUMANTH MULAMALLA (MD) is a healthcare provider. based in Dyer, Indiana. specializing in NEPHROLOGY. They hold the professional credentials MD. They hold a License No. 01065980A (IN). The NPI Number for DR. SUMANTH MULAMALLA (MD) is 1003019647

Main info

Male
23 Years Of Experience
Accepts Medicare Assignment
Name
DR. SUMANTH MULAMALLA (MD)
NPI
1003019647
Phone
(219) 365-6333
Address
15900 W 101ST AVE
Enumeration Date
11 June 2007
Last Update Date
21 April 2016

Doctor Profile

Medical School Name
EASTERN VIRGINIA MEDICAL SCHOOL
Secondary Phone
8553507365
Graduation Year
2003 (23 years ago)
PAC ID
8022160878
Group Practice PAC ID
5496040065
Professional Enrollment ID
I20191218000565
Address ID
TN372192509NA511XXSTXX301
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

269 NEPHROLOGY in IN

Provider Addresses for DR. SUMANTH MULAMALLA (MD)

  • 15900 W 101ST AVE

    DYER, IN 463113065

    Phone: (219) 365-6333

    Fax: (219) 365-8291

    Type: Location

  • The Edge Lofts and Tower, 210, South Desplaines Street, Greektown, Near West Side, University Village/Little Italy, Chicago, Cook County, Illinois, 60661, United States

    CHICAGO, IL 606615500

    Phone: (312) 654-2700

    Fax: (312) 654-9930

    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: 2025-11-05

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 5 Medicare enrollment records; no due dates published yet.

Enrollment records

5

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
I20121019000164INephrologyINTBD
I20191218000565INephrologyTNTBD
I20210524002077INephrologyOKTBD
I20240906002379INephrologyNCTBD
I20251105000235INephrologyNETBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
G0407Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth314102$0
G0408Follow-up inpatient consultation, complex, physicians typically spend 35 minutes communicating with the patient via telehealth6531$0
G0426Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth6559$0
G0427Telehealth consultation, emergency department or initial inpatient, typically 70 minutes or more communicating with the patient via telehealth3231$0
View full utilization report →

Insurance plans in this area (ZIP 46311)

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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: 5496040065View full group profile
NameSpecialtyState
N E P H R O L O G YOH
Nephrology, Internal MedicineNV
N E P H R O L O G YTN
N E P H R O L O G YNV

Reviews

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Frequently asked questions

What NPI should I save for DR. SUMANTH MULAMALLA (MD)?
Save NPI 1003019647 if you need a stable reference for DR. SUMANTH MULAMALLA (MD).
Is DR. SUMANTH MULAMALLA (MD)'s NPI currently valid?
The extract we use shows DR. SUMANTH MULAMALLA (MD) as active.
What does DR. SUMANTH MULAMALLA (MD) treat or focus on?
Patients typically see DR. SUMANTH MULAMALLA (MD) under the specialty Nephrology Physician. Clinical services aligned with this taxonomy classification.
Where is DR. SUMANTH MULAMALLA (MD)'s primary listing?
We display Dyer, Indiana because that is what the record indicates for DR. SUMANTH MULAMALLA (MD).
How can I contact DR. SUMANTH MULAMALLA (MD)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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