NPIMap

Individual provider Active NPI

Shiva Kumar Reddy Mukkamalla, MD, MPH

  • Hematology (Internal Medicine) Physician
  • Indiana, PA
National Provider Identifier
1013268077
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology (Internal Medicine) PhysicianTaxonomy code 207RH0000X
License
MD2017-0778 Issued in NM
Practice address
Irmc Cancer Center 850 Hospital Road First Floor
Suite 1300
Indiana, PA 15701
Phone
(724) 349-9444
NPI assigned
Sep 30, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Hematology (Internal Medicine) Physician 207RH0000X MD2017-0778 NM Primary

Addresses

Primary practice location

Irmc Cancer Center 850 Hospital Road First Floor
Suite 1300
Indiana, PA 15701

Mailing address

Irmc Cancer Center 850 Hospital Road
Suite 1300
Indiana, PA 15701
Phone (724) 349-9444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20231220002600 PA Practitioner - Medical OncologyPractitioner - Hematology 6709141666 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Medical OncologyAlso: Hematology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Keystone Rehabilitation Systems IncGroup PAC ID 7012826753, shared by 15 NPIs, 750 clinicians
Oncology Hematology Association IncGroup PAC ID 9830003300, 201 clinicians

Practice addresses (Care Compare)

205 Hampton Ave
Punxsutawney, PA 15767-2133
Phone (814) 938-0148

850 Hospital Rd
Suite 1300
Indiana, PA 15701-3662
Phone (724) 349-9444

Hospital & facility affiliations

  • Indiana Regional Medical Center Hospital, Indiana, PA, CCN 390173
  • Punxsutawney Area Hospital Hospital, Punxsutawney, PA, CCN 390199
  • Penn Highlands Dubois Hospital, Dubois, PA, CCN 390086
  • Excela Health Latrobe Hospital Hospital, Latrobe, PA, CCN 390219
  • Conemaugh Miners Medical Center Hospital, Hastings, PA, CCN 391317

Merit-based Incentive Payment System (MIPS)

Final score
88.68 of 100Reported as group
Quality
82.35
Promoting interoperability
100
Improvement activities
40
Cost
76.6

Merit-based Incentive Payment System (MIPS)

Final score
64.81 of 100Reported as group
Quality
42.46
Improvement activities
40
Cost
76.23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2017-0778NMMDHematology (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Butler Cancer Associates Inc CurrentSince Dec 27, 2023 Accepting new patients
Oncology Hematology Association Inc CurrentSince Dec 27, 2023 Accepting new patients
Oncology Hematology Association CurrentSince Dec 27, 2023 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

129 Oneida Valley Rd
Ste 311
Butler, PA 16001
Phone (724) 482-2717

102 Technology Dr
Ste 110
Butler, PA 16001
Phone (724) 282-6175

835 Hospital Rd
Indiana, PA 15701
Phone (724) 357-7000

850 Hospital Rd
Ste 1300
Indiana, PA 15701
Phone (724) 349-9444

5115 Centre Ave
Fl 3
Pittsburgh, PA 15232
Phone (412) 235-1020

2 Hot Metal St
#One
Pittsburgh, PA 15203
Phone (412) 432-5864

Organizations & group practices 4

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

Hospital & facility affiliations 41

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

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1348963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1013268077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "IRMC CANCER CENTER 850 HOSPITAL ROAD",
            "address_2": "SUITE 1300",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "15701",
            "telephone_number": "724-349-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "IRMC CANCER CENTER 850 HOSPITAL ROAD FIRST FLOOR",
            "address_2": "SUITE 1300",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "15701",
            "telephone_number": "724-349-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKKAMALLA",
        "first_name": "SHIVA KUMAR",
        "middle_name": "REDDY",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-30",
        "last_updated": "2024-03-25",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "NM",
            "license": "MD2017-0778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indiana, PA

Sources for this page

Verify at the official NPI Registry.