SUPRAJA R. GULLA (MD) – Internal Medicine Physician, NPI 1104076389
Preparing for Medicare enrollment?
Use our CMS-855 prep checklist: which form applies (855I, 855O, or 855A), readiness score, NPPES field map, and Section 12 documents. Reassignment uses CMS-855I Section 4F—not the discontinued CMS-855R form.
Open Medicare 855 Prep tool →Internal Medicine Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Loading map...
Provider Addresses for SUPRAJA R. GULLA (MD)
1800, North Capitol Avenue, Meridian Highlands, Indianapolis, Marion, Indiana, 46202, United States
SUITE E140
INDIANAPOLIS, IN 46202
Phone: (317) 962-2894
Fax: (317) 963-5285
Type: Location
North Shadeland Avenue, Castleton, Vertland, Indianapolis, Indiana, 46250, United States
STE 130 PROVIDER ENROLLMENT
INDIANAPOLIS, IN 462194959
Phone:
Type: Mailing
4945 WILLIAMS DR
GEORGETOWN, TX 786332008
Phone: (317) 962-2894
Type: Location
PO BOX 844658
DALLAS, TX 752844658
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $40.
Total Amount is formed as General ($40) + Research ($0) + Ownership ($0) = $40.
Last reported payment date: 2024-04-18 • Largest payer in this snapshot: PFIZER INC. ($21).
Total Amount
$40
General + Research + Ownership
Payments
2
Total payment records
General Amount
$40
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| PFIZER INC. | $21 |
| Lilly USA, LLC | $18 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 163 | 119 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 69 | 62 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 40 | 40 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 17 | 17 | $0 |
Insurance plans in this area (ZIP 46202)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Infectious Disease | PA | |
| - | NC |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.