Individual provider Active NPI

Madhu G. Jyothinagaram, MD

  • Cardiovascular Disease Physician
  • Fort Wayne, IN
National Provider Identifier
1114983491
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
01089030A Issued in IN
Practice address
7916 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone
(260) 432-2297
Fax
(260) 434-6433
NPI assigned
Apr 25, 2006
Last updated
Aug 14, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 01089030A IN Primary

Addresses

Primary practice location

7916 W Jefferson Blvd
Fort Wayne, IN 46804-4140

Mailing address

6920 Pointe Inverness Way Ste 200
Fort Wayne, IN 46804-7934
Phone (260) 479-3514

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address madhu.jyothinagaram@lutheranhealthnetwork.cernerdirect.com

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20221222001601 IN Practitioner - Cardiovascular Disease (Cardiology) 8224027016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lutheran Medical Group LLCGroup PAC ID 4981751617, 251 clinicians

Practice addresses (Care Compare)

7916 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 432-2297

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.99 of 100Reported as apm
Quality
77.41
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01089030AINMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Medical Group LLC Cardiovascular Disease CurrentSince Jan 1, 2023 Accepting new patients
Lutheran Medical Group LLC CurrentSince Jan 1, 2023 Accepting new patients

Locations

303 S Main St
Bluffton, IN 46714
Phone (260) 824-0800

955 High St
Ste 3
Decatur, IN 46733
Phone (219) 724-2125

2512 E DuPont Rd
Ste 110
Fort Wayne, IN 46825
Phone (260) 434-6076

2516 E DuPont Rd
Fort Wayne, IN 46825
Phone (260) 434-6076

2520 E DuPont Rd
Fort Wayne, IN 46825
Phone (219) 407-8000

6515 Stellhorn Rd
Ste 200
Fort Wayne, IN 46815
Phone (260) 458-3212

6920 Pointe Inverness Way
Ste 200
Fort Wayne, IN 46804
Phone (260) 479-3514

702 Van Buren St
Fort Wayne, IN 46802
Phone (260) 425-3000

7910 W Jefferson Blvd
Ste 120
Fort Wayne, IN 46804
Phone (260) 435-7612

7916 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 432-2298

7950 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-7088

7952 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 435-2836

800 Broadway
Ste 200
Fort Wayne, IN 46802
Phone (260) 458-3410

1205 Provident Dr
#A
Warsaw, IN 46580
Phone (574) 269-8383

2101 Dubois Dr
Warsaw, IN 46580
Phone (219) 267-3200

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1114983491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6920 POINTE INVERNESS WAY STE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047934",
            "telephone_number": "260-479-3514",
            "fax_number": "260-479-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7916 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044140",
            "telephone_number": "260-432-2297",
            "fax_number": "260-434-6433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JYOTHINAGARAM",
        "first_name": "MADHU",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IN",
            "license": "01089030A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "madhu.jyothinagaram@lutheranhealthnetwork.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "address_1": "7916 W Jefferson Blvd",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468044140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.