Individual provider Active NPI

Lokesh R Edara, MD

  • Allergy Physician
  • Battle Creek, MI
National Provider Identifier
1104890490
Registry record updated Aug 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
LE055658 Issued in MI
Practice address
126 College St
Battle Creek, MI 49017-3461
Phone
(269) 968-3622
Fax
(269) 968-2103
NPI assigned
Feb 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X LE055658 MI Primary

Addresses

Primary practice location

126 College St
Battle Creek, MI 49017-3461

Mailing address

49 S Cass St
Suite 1B
Battle Creek, MI 49017-2331
Phone (269) 969-8920

Other identifiers 1

IdentifierTypeStateIssuer
102640222MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20050419001318 MI Practitioner - Allergy/Immunology 8820035249 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Asthma Allergy Centers PCGroup PAC ID 9931146347, 9 clinicians

Practice addresses (Care Compare)

126 College St
Battle Creek, MI 49037-3461
Phone (269) 968-3030

1324 W Milham Ave
Suite 1
Portage, MI 49024-2239
Phone (269) 342-0196

360 E Chicago St
Suite 109
Coldwater, MI 49036-2074
Phone (517) 278-9025

833 Laurence Ave
Jackson, MI 49202-2981
Phone (517) 782-1700

Hospital & facility affiliations

  • Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017
  • Bronson Battle Creek Hospital Hospital, Battle Creek, MI, CCN 230075

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LE055658MIMDAllergy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pradhan Center for Women PLC Past Accepting new patients
Asthma Allergy Care Centers PC Allergy PastSince Jan 1, 2006 Accepting new patients

Organizations & group practices 3

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": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313366400000",
    "number": "1104890490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 S CASS ST",
            "address_2": "SUITE 1B",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490172331",
            "telephone_number": "269-969-8920",
            "fax_number": "269-969-8921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 COLLEGE ST",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490173461",
            "telephone_number": "269-968-3622",
            "fax_number": "269-968-2103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDARA",
        "first_name": "LOKESH",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2011-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "MI",
            "license": "LE055658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102640222",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Creek, MI

Sources for this page

Verify at the official NPI Registry.