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

Individual provider Internal Medicine Physician · NPI 1043258023

Dr. Kesavarao Mittapalli, MD is an Internal Medicine in Hackensack, New Jersey. Qualified in 1979, 47 years ago. Practices with Hackensack Meridian Health Medical Group - Specialty Care PC, a 1,897-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
47
Licensed in
NJ
In the registry since
2006
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

30 Prospect Ave Faculty Practice Ofc
Hackensack, NJ 07601-1914
Phone: (201) 996-2816
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 25MA05903900 (NJ)

Record details

NPI number1043258023
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 3, 2006
Last updated in NPPESJuly 8, 2007

Medicare enrollment

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

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 1979 (47 years in practice)
Group practice Hackensack Meridian Health Medical Group - Specialty Care Pc — 1897 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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