Prem K Konakondla, M.D.,

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

01067488A Issued in IN

Practice address

2001 W 86TH St
Indianapolis, IN 46260-1902

Phone

(317) 338-2345

NPI assigned

Jun 5, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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

Internal Medicine

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hendricks County HospitalGroup PAC ID 4880505528, 341 clinicians

St Vincent Physician Services Hospital and Health Care CenterGroup PAC ID 9638072184, 276 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St Vincent Hospital Hospital, Indianapolis, IN, CCN 150084
• Hendricks Regional Health Hospital, Danville, IN, CCN 150005
• Ascension St Vincent Kokomo Hospital, Kokomo, IN, CCN 150010

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://sehproxy.stelizabeth.com/arr-fhir/api/FHIR/R4
• Direct secure messaging: pkonakondla419335@direct-prd.stelizabeth.com

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.

• Hendricks County Hospital

  • General Practice Physician
  • Danville, IN
  • NPI 1497536163
  Medicare reassignment Care Compare group NPD
• St Vincent Physician Services Hospital and Health Care Center

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1669422234

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Hancock Physician Network, LLC

  • Family Medicine Physician
  • Greenfield, IN
  • NPI 1609806470

  Internal Medicine

  Medicare reassignment NPD
• Hendricks County Hospital

  • Hospitalist Physician
  • Danville, IN
  • NPI 1316048754
  NPD
• Hendricks County Hospital

  • Pediatrics Physician
  • Brownsburg, IN
  • NPI 1508758210
  NPD
• St Vincent Physician Services Hospital and Health Care Center

  • Durable Medical Equipment & Medical Supplies
  • Carmel, IN
  • NPI 1366689044
  NPD
• Hendricks County Hospital

  • Urgent Care Clinic/Center
  • Avon, IN
  • NPI 1063411551
  NPD (past)
• Hendricks County Hospital

  • Family Medicine Physician
  • Plainfield, IN
  • NPI 1104927557
  NPD (past)
• Hendricks County Hospital

  • Family Medicine Physician
  • Avon, IN
  • NPI 1598993784
  NPD (past)
• 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.

• Hendricks County Hospital

  • General Acute Care Hospital
  • Danville, IN
  • NPI 1669475950
  Care Compare affiliation
• St. Joseph Hospital & Health Center, Inc.

  • General Acute Care Hospital
  • Kokomo, IN
  • NPI 1780625442
  Care Compare affiliation
• St. Vincent Hospital & Health Care Center, Inc.

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1306898960
  Care Compare affiliation
• St. Vincent Hospital & Health Care Center, Inc.

  • General Acute Care Hospital
  • Avon, IN
  • NPI 1851833230
  Care Compare affiliation

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1114186913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 W 86TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 W 86TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601902",
            "telephone_number": "317-338-2345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 E County Line Rd",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "IN",
            "postal_code": "461431072",
            "country_code": "US",
            "telephone_number": "317-885-2860",
            "fax_number": "317-885-2869",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8050 Township Line Rd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462602478",
            "country_code": "US",
            "telephone_number": "317-415-8500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 E Main St",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "IN",
            "postal_code": "461221948",
            "country_code": "US",
            "telephone_number": "317-718-4740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KONAKONDLA",
        "first_name": "PREM",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-05",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "11014069A",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "IN",
            "license": "01067488A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01067488A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200979950",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pkonakondla419335@direct-PRD.stelizabeth.com",
            "affiliation": "N",
            "address_1": "1000 E Main St",
            "city": "Danville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461221948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Smruthi Kommineni
• Saritha Kumari Kompally
• Cayleigh Kompare
• Kompassionate Care Services LLC
• Komplete Kare Transportation Services LLC
• Kasyap Krishna Kondury, MD
• Thomas Joseph Konechnik, LMHCA
• Hailey Eileen Konermann, MA
• Mridula Koneru, PHARMD
• Sarah Kong

• Internal Medicine Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; 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.