Individual provider Active NPI

Padmaja Chilukoti, MBBS, DGO

  • Pediatric Endocrinology Physician
  • Ashtabula, OH
National Provider Identifier
1053704148
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
35.129784 Issued in OH
Practice address
2422 Lake Ave
Ashtabula, OH 44004-4985
Phone
(440) 997-6980
NPI assigned
Mar 12, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35.129784 OH
Pediatric Endocrinology Physician 2080P0205X MD474304 PA
Pediatric Endocrinology Physician 2080P0205X 35.129784 OH Primary

Addresses

Primary practice location

2422 Lake Ave
Ashtabula, OH 44004-4985

Mailing address

2422 Lake Ave
Ashtabula, OH 44004-4985
Phone (440) 997-6980

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
I20171005002580 OH Practitioner - EndocrinologyPractitioner - Pediatric Medicine 5597030205 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ashtabula County Medical CenterGroup PAC ID 2668465600, 70 clinicians

Practice addresses (Care Compare)

2422 Lake Ave
Ashtabula, OH 44004-4985
Phone (440) 997-6969

Hospital & facility affiliations

  • Ashtabula County Medical Center Hospital, Ashtabula, OH, CCN 360125
  • Uhhs Memorial Hospital of Geneva Hospital, Geneva, OH, CCN 361307

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.129784OHMDPediatric Endocrinology Physician
MD474304PAMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ashtabula County Medical Center CurrentSince Sep 1, 2023 Accepting new patients

Locations

2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919

2422 Lake Ave
Ashtabula, OH 44004
Phone (440) 992-4422

Organizations & group practices 1

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 2

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": "1426118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1053704148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2422 LAKE AVE",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440044985",
            "telephone_number": "440-997-6980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2422 LAKE AVE",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440044985",
            "telephone_number": "440-997-6980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILUKOTI",
        "first_name": "PADMAJA",
        "credential": "MBBS, DGO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-12",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.129784",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "PA",
            "license": "MD474304",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "OH",
            "license": "35.129784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashtabula, OH

Sources for this page

Verify at the official NPI Registry.