NPIMap

Individual provider Active NPI

Venkata K Chalasani, M.D.

  • Internal Medicine Physician
  • Wapakoneta, OH
National Provider Identifier
1164525952
Registry record updated Aug 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35074822 Issued in OH
Practice address
812 Redskin TRL Ste a
Wapakoneta Primary Care
Wapakoneta, OH 45895-8545
Phone
(419) 738-4445
Fax
(419) 738-4601
NPI assigned
Sep 7, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 11

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 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Family Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Joint Township District Memorial Hospital 39 clinicians
JTDM Family Practice LLC 48 clinicians

Practice addresses (Care Compare)

200 Saint Clair Ave
Saint Marys, OH 45885-2400
Phone 41939433353569

812 Redskin TRL
Suite a
Wapakoneta, OH 45895-8545
Phone (419) 738-4445

Hospital & facility affiliations

  • New Vision Nursing and Home Care, LLC Home health agency, Wapakoneta, OH, CCN 368219
  • Grand Lake Health System Hospital, Saint Marys, OH, CCN 360032
  • Lima Memorial Health System Hospital, Lima, OH, CCN 360009
  • Mercy Health St Ritas Medical Center Hospital, Lima, OH, CCN 360066
  • Miami Valley Hospital Hospital, Dayton, OH, CCN 360051
  • Mercer County Joint Township Community Hospital Hospital, Coldwater, OH, CCN 360058
  • Transitional Care Unit Nursing home, Saint Marys, OH, CCN 365807

Merit-based Incentive Payment System (MIPS)

Final score
85.44 of 100Reported as group
Quality
78
Promoting interoperability
96
Improvement activities
40
Cost
76.79

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100119000026 OH Practitioner - Internal MedicinePractitioner - Family PracticePractitioner - Geriatric Medicine 2769524438 Reassigns benefits to 2 organizations

All facility ownership & control disclosures 1

Medicare enrollment files

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Grand Lake Physician PracticesSaint Marys, OH, CCN 365807 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 1, 2013
Mar 1, 2013

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35074822OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
JTDM Family Practice LLC CurrentSince Jan 22, 2014 Accepting new patients
Joint Township District Memorial Hospital CurrentSince Sep 1, 2003 Accepting new patients
Lima Memorial Joint Operating Company PastSince Jan 22, 2014 Accepting new patients
Dr. Ranga Inc. Past Accepting new patients
Chalasani MD Inc. Internal Medicine PastSince Nov 21, 2017 Accepting new patients

Locations

800 W Main St
Coldwater, OH 45828
Phone (419) 678-2341

4463 State Route 66
Ste A
Minster, OH 45865
Phone (419) 628-3821

1040 Hager St
Saint Marys, OH 45885
Phone (419) 394-9959

200 Saint Clair Ave
Saint Marys, OH 45885
Phone (419) 394-3387

711 Gibbs Ave
Wapakoneta, OH 45895
Phone (419) 738-4445

812 Redskin Trl
#C
Wapakoneta, OH 45895
Phone (419) 738-4445

812 Redskin Trl
Ste A
Wapakoneta, OH 45895
Phone (419) 738-4445

812 Redskin Trl
Wapakoneta, OH 45895
Phone (419) 586-6489

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35074822 OH Primary

Addresses

NPPES NPI Registry

Primary practice location

812 Redskin TRL Ste a
Wapakoneta Primary Care
Wapakoneta, OH 45895-8545

Mailing address

200 Saint Clair Ave
JTDM Family Practice, LLC
Saint Marys, OH 45885-2400
Phone (419) 394-3387

Other identifiers 5

NPPES NPI Registry
IdentifierTypeStateIssuer
H280550OtherOHMEDICARE INDIVIDUAL PTAN
0705982OtherOHMEDICAID LEGACY
9934723OtherOHMEDICARE GROUP PTAN
1356772255OtherOHGROUP NPI -WAPAKONETA PRIMARY CARE
2090115MedicaidOH

Electronic endpoints 1

NPPES NPI Registry
TypeEndpointUseAffiliation
Direct Messaging Address venkatachalasani@glhs.allscriptsdirect.net

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 5, 2020.

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1164525952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SAINT CLAIR AVE",
            "address_2": "JTDM FAMILY PRACTICE, LLC",
            "city": "SAINT MARYS",
            "state": "OH",
            "postal_code": "458852400",
            "telephone_number": "419-394-3387",
            "fax_number": "419-738-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 REDSKIN TRL STE A",
            "address_2": "WAPAKONETA PRIMARY CARE",
            "city": "WAPAKONETA",
            "state": "OH",
            "postal_code": "458958545",
            "telephone_number": "419-738-4445",
            "fax_number": "419-738-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHALASANI",
        "first_name": "VENKATA",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35074822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL PTAN",
            "identifier": "H280550",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID LEGACY",
            "identifier": "0705982",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "9934723",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI -WAPAKONETA PRIMARY CARE",
            "identifier": "1356772255",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2090115",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "venkatachalasani@glhs.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "812 Redskin Trl Ste A",
            "address_2": "Wapakoneta Primary Care",
            "city": "Wapakoneta",
            "state": "OH",
            "country_code": "US",
            "postal_code": "458958545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wapakoneta, OH

Sources for this page

Verify at the official NPI Registry.