Individual provider Active NPI

Raghu Kolluri, M.D.

  • Internal Medicine Physician
  • Columbus, OH
National Provider Identifier
1053495325
Registry record updated Jan 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.083979 Issued in OH
Practice address
3705 Olentangy River Rd
Suite 100
Columbus, OH 43214-3467
Phone
(614) 262-6772
Fax
(614) 533-0162
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 35.083979 OH
Internal Medicine Physician 207R00000X 35.083979 OH Primary

Addresses

Primary practice location

3705 Olentangy River Rd
Suite 100
Columbus, OH 43214-3467

Mailing address

PO Box 7527
Dublin, OH 43017-0727

Other identifiers 1

IdentifierTypeStateIssuer
0082537MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rkolluri32204@direct.ohiohealth.com OhioHealth Physician Group

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
I20050314000024 OH Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Other (Physician)Practitioner - Vascular SurgeryPractitioner - Peripheral Vascular Disease 1658326673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Peripheral Vascular Disease, Vascular Surgery
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians

Practice addresses (Care Compare)

3705 Olentangy River Rd
Suite 100
Columbus, OH 43214-3467
Phone (614) 262-6772

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.04 of 100Reported as group
Quality
58.67
Promoting interoperability
98
Improvement activities
40
Cost
76.46

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal41
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.083979OHMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation Internal Medicine Current Accepting new patients
Ohiohealth Corporation CurrentSince Aug 12, 2013 Accepting new patients
Ohiohealth Corporation CurrentSince Aug 12, 2013 Accepting new patients
HSHS Medical Group Inc Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

3705 Olentangy River Rd
Ste 100
Columbus, OH 43214

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

3705 Olentangy River Rd
Columbus, OH 43214
Phone (614) 533-6620

Dept L3652
Columbus, OH 43260

5350 Frantz Rd
Dublin, OH 43016

5400 Frantz Rd
Ste 250
Dublin, OH 43016
Phone (614) 544-6161

7450 Hospital Dr
Ste 460
Dublin, OH 43016
Phone (614) 533-4999

Organizations & group practices 5

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 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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1053495325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7527",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430170727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 OLENTANGY RIVER RD",
            "address_2": "SUITE 100",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143467",
            "telephone_number": "614-262-6772",
            "fax_number": "614-533-0162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLURI",
        "first_name": "RAGHU",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OH",
            "license": "35.083979",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.083979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0082537",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rkolluri32204@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group",
            "address_1": "3705 Olentangy River Rd",
            "address_2": "Ste 100",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432143467",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.