Shiva Prasad Gangadhar, M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

01075188A Issued in IN

Practice address

6330 E 75TH St
Ste 110
Indianapolis, IN 46250-2777

Phone

(317) 588-7149

Fax

(317) 588-7150

NPI assigned

Mar 12, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Physical Medicine and Rehabilitation

Education

Indiana University School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rehabilitation Associates of in PCGroup PAC ID 1557256740, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Hospital East Hospital, Indianapolis, IN, CCN 150074
• Community Hospital North Hospital, Indianapolis, IN, CCN 150169
• Franciscan Health Indianapolis Hospital, Indianapolis, IN, CCN 150162
• Indiana University Health Hospital, Indianapolis, IN, CCN 150056
• Community Health Network Rehabilitation Hospital Inpatient rehabilitation facility, Indianapolis, IN, CCN 153043
• Community Health Network Rehabilitation Hosp So Inpatient rehabilitation facility, Greenwood, IN, CCN 153044

Merit-based Incentive Payment System (MIPS)

Final score

97.51 of 100Reported as group

Quality

84.51

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Rehabilitation Associates of in PC

  • Physical Medicine & Rehabilitation Physician
  • Indianapolis, IN
  • NPI 1316929128
  Medicare reassignment Care Compare group NPD
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

• Community Health Network Rehabilitation Hospital LLC

  • Rehabilitation Hospital
  • Indianapolis, IN
  • NPI 1114268810

  Inpatient rehabilitation facility

  Care Compare affiliation
• Community Health Network Rehabilitation Hospital South, LLC

  • Rehabilitation Hospital
  • Greenwood, IN
  • NPI 1790285500

  Inpatient rehabilitation facility

  Care Compare affiliation
• Community Health Network, Inc

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1336119478
  Care Compare affiliation
• Community Health Network, Inc

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1619163854
  Care Compare affiliation
• Franciscan Health Indianapolis & Mooresville

  • General Acute Care Hospital
  • Carmel, IN
  • NPI 1376214981
  Care Compare affiliation
• Franciscan Health Indianapolis & Mooresville

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1386749893
  Care Compare affiliation
• Indiana University Health Inc

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1144266024
  Care Compare affiliation

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

{
    "created_epoch": "1331510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1043585946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6330 E 75TH ST STE 110",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502717",
            "telephone_number": "317-588-7130",
            "fax_number": "317-588-7133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6330 E 75TH ST",
            "address_2": "STE 110",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502777",
            "telephone_number": "317-588-7149",
            "fax_number": "317-588-7150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANGADHAR",
        "first_name": "SHIVA",
        "middle_name": "PRASAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-12",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IN",
            "license": "01075188A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201109490",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sgangadhar@directaddress.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6330 E 75th St",
            "address_2": "Ste 110",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462502777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rachael D Gandolph, DDS
• Priyanthie Ganenthiran, MD
• Gautham Ganesan, MD
• Lakshmi Ganesan, DDS
• Anjana L Ganeshappa, M.D.
• Ritu Gangadhara
• Nilesh Gangan
• Kelsey Nicole Gangnon, LMHCA
• Priya Gangwani, PT
• Charlotte I Gangwer, RN, NP

• Physical Medicine & Rehabilitation Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Physical Medicine & Rehabilitation Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.