Individual provider Active NPI

Rukmini R Komarlu, M.D.

  • Pediatric Cardiology Physician
  • Cleveland, OH
National Provider Identifier
1023323532
Registry record updated Nov 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
35.123305 Issued in OH
Practice address
9500 Euclid Ave
Cleveland, OH 44195-5724
Phone
(216) 444-0450
Fax
(216) 445-3692
NPI assigned
Aug 10, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 252248 MA
Pediatric Cardiology Physician 2080P0202X 35.123305 OH Primary

Addresses

Primary practice location

9500 Euclid Ave
Cleveland, OH 44195-5724

Mailing address

9500 Euclid Ave
Cleveland, OH 44195-5724
Phone (216) 386-4015

Other identifiers 1

IdentifierTypeStateIssuer
01068597AOtherININDIANA LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140428001079 OH Practitioner - Pediatric Medicine 7911183405 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Cleveland University of Medicine and Surgery - NLG, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

8950 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-8950

9500 Euclid Ave
Cleveland, OH 44195-0001

Hospital & facility affiliations

  • Cleveland Clinic Hospital, Cleveland, OH, CCN 360180

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
252248MAMDPediatric Cardiology Physician
35.123305OHMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wooster Clinic, LLC CurrentSince Mar 6, 2015 Accepting new patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
The Cleveland Clinic Foundation CurrentSince Apr 11, 2014 Accepting new patients
Midwest Pediatric Cardiology, P.C. Pediatric Cardiology Past Accepting new patients

Locations

551 Washington St
Chagrin Falls, OH 44022
Phone (440) 893-9393

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

1740 Cleveland Rd
Wooster, OH 44691
Phone (330) 287-4500

Interoperability endpoints

  • Direct secure messaging: rkomarlu57704@direct.ccf.org

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 1

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": "1281398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1023323532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441955724",
            "telephone_number": "216-386-4015",
            "fax_number": "216-445-3692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441955724",
            "telephone_number": "216-444-0450",
            "fax_number": "216-445-3692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMARLU",
        "first_name": "RUKMINI",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-10",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MA",
            "license": "252248",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "OH",
            "license": "35.123305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA LICENSE",
            "identifier": "01068597A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.