Individual provider Active NPI

Sri Krishna Chaitany Arudra, M.D.

  • Dermatopathology (Pathology) Physician
  • Toledo, OH
National Provider Identifier
1134475734
Registry record updated May 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X
License
15166 Issued in ND
Practice address
3000 Arlington Ave
Mail Stop 1068
Toledo, OH 43614-2595
Phone
(419) 383-4244
NPI assigned
Aug 1, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology (Pathology) Physician 207ZD0900X 15166 ND Primary

Addresses

Primary practice location

3000 Arlington Ave
Mail Stop 1068
Toledo, OH 43614-2595

Mailing address

3000 Arlington Ave
Mail Stop 1068
Toledo, OH 43614-2595
Phone (419) 383-4244

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180726002438 ND Practitioner - Other (Physician) 1456608157 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15166NDMDDermatopathology (Pathology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Bismarck CurrentSince Jul 5, 2018 Accepting new patients
Sanford Bismarck CurrentSince Jul 5, 2018 Accepting new patients

Locations

3318 N 14th St
Bismarck, ND 58503
Phone (701) 323-8300

222 N 7th St
Bismarck, ND 58501
Phone (701) 323-5422

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1343779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558051200000",
    "number": "1134475734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 ARLINGTON AVE",
            "address_2": "MAIL STOP 1068",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436142595",
            "telephone_number": "419-383-4244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 ARLINGTON AVE",
            "address_2": "MAIL STOP 1068",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436142595",
            "telephone_number": "419-383-4244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARUDRA",
        "first_name": "SRI KRISHNA CHAITANY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-01",
        "last_updated": "2019-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "ND",
            "license": "15166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.