Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Ganapathi Gottumukkala, MD

Individual provider Family Medicine Physician · NPI 1780683953

Dr. Ganapathi Gottumukkala, MD is a Family Practice in Saint John, Indiana. Qualified in 1983, 43 years ago. Practices with Community Care Network Inc, a 374-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Illinois and Indiana.

Years since qualifying
43
Licensed in
IL, IN
In the registry since
2005
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

9660 Wicker Ave
Saint John, IN 46373-9487
Phone: (193) 651-1772
Fax: (219) 703-6662
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 15300 West Ave Ste 20, Orland Park, IL 60462-4504 — (708) 460-5550
  • 6701 159th St, Tinley Park, IL 60477-1758 — (708) 614-0893

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 01086883A (IN)
Family Medicine Physician Taxonomy 207Q00000X · Licence 036074987 (IL)

Record details

NPI number1780683953
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJuly 19, 2005
Last updated in NPPESSeptember 3, 2024
Certification dateSeptember 3, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 1983 (43 years in practice)
Group practice Community Care Network Inc — 374 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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