NPIMap

Individual provider Active NPI

Prasad R Kudalkar, MD

  • Hematology & Oncology Physician
  • Fairfield, OH
National Provider Identifier
1013094382
Registry record updated Apr 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
35089286 Issued in OH
Practice address
3050 Mack Rd Ste 300
Fairfield, OH 45014-5376
Phone
(513) 751-2273
Fax
(513) 751-1840
NPI assigned
Nov 1, 2006
Last updated
Apr 19, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 35089286 OH Primary

Addresses

Primary practice location

3050 Mack Rd Ste 300
Fairfield, OH 45014-5376

Mailing address

5053 Wooster Rd
Cincinnati, OH 45226-2326
Phone (513) 751-2145

Other identifiers 3

IdentifierTypeStateIssuer
7100178540MedicaidKY
2762685MedicaidOH
201041210MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address prasad.kudalkar@ohc.ikm.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070926000426 OH Practitioner - Hematology/OncologyPractitioner - Internal Medicine 0042267783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oncology Hematology Care IncGroup PAC ID 8921910373, 63 clinicians

Practice addresses (Care Compare)

3050 Mack Rd
Suite 300
Fairfield, OH 45014-5376
Phone (513) 682-4800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Oncology Hematology Care Inc Hematology & Oncology CurrentSince Oct 31, 2011 Accepting new patients
Oncology-Hematology Care Inc Hematology & Oncology Past Accepting new patients
Compassionate Cancer Care & Research Past Accepting new patients
Mohave Medical Oncology Center Hematology & Oncology Past Accepting new patients
Dayton Physicians, LLC Past Accepting new patients
Dayton Physicians, LLC Hematology & Oncology Past Accepting new patients

Locations

4350 Malsbary Rd
Blue Ash, OH 45242
Phone (800) 710-4674

3301 Mercy Health Blvd
Ste 100
Cincinnati, OH 45211
Phone (513) 751-2145

4777 E Galbraith Rd
Ste 320
Cincinnati, OH 45236

5053 Wooster Rd
Cincinnati, OH 45226
Phone (513) 751-2145

3050 Mack Rd
Ste 300
Fairfield, OH 45014
Phone (513) 682-4800

Networks

  • KY PPO
  • devoted network organization-8ee96498-f86e-45f6-9fc9-a0f06c1636f9
  • devoted network organization-2d523d8e-e8f9-454a-bcd3-333df65bdbe8
  • KY PPO C-SNP
  • devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6
  • devoted network organization-9f3dfbd3-4aa6-4c92-8e71-9c4ed35ce037
  • OH PPO

Interoperability endpoints

  • Direct secure messaging: prasad.kudalkar@ohc.ikm.direct-ci.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1013094382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5053 WOOSTER RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452262326",
            "telephone_number": "513-751-2145",
            "fax_number": "513-751-2138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 MACK RD STE 300",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145376",
            "telephone_number": "513-751-2273",
            "fax_number": "513-751-1840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUDALKAR",
        "first_name": "PRASAD",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "OH",
            "license": "35089286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100178540",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2762685",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201041210",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "prasad.kudalkar@ohc.ikm.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3050 Mack Rd Ste 300",
            "city": "Fairfield",
            "state": "OH",
            "country_code": "US",
            "postal_code": "450145376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairfield, OH

Sources for this page

Verify at the official NPI Registry.