Individual provider Active NPI

Hulimangala Rajasekharareddy Rakesh, M.D

  • Anesthesiology Physician
  • Wexford, PA
National Provider Identifier
1164632402
Registry record updated Oct 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD435081 Issued in PA
Practice address
623 Ciderberry Dr
Wexford, PA 15090-6831
Phone
(412) 614-0797
NPI assigned
May 23, 2007
Last updated
Oct 9, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 4301083141 MI
Anesthesiology Physician 207L00000X MD435081 PA Primary

Addresses

Primary practice location

623 Ciderberry Dr
Wexford, PA 15090-6831

Mailing address

623 Ciderberry Dr
Wexford, PA 15090-6831
Phone (412) 614-0797

Other practice location 1

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-8234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180209000546 PA Practitioner - Anesthesiology 8123203437 Reassigns benefits to 1 organization
I20210224001055 TX Practitioner - Anesthesiology 8123203437 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permian Basin Anesthesia PLLCGroup PAC ID 4587094313, 4 clinicians

Practice addresses (Care Compare)

400 Rosalind Redfern Grover Pkwy
Midland, TX 79701-5846
Phone (432) 221-1111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301083141MIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians Anesthesiology CurrentSince Jan 1, 2018 Accepting new patients
University of Pittsburgh Physicians CurrentSince Jan 1, 2018 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients
Permian Basin Anesthesia P.L.L.C. Anesthesiology CurrentSince Jan 15, 2021 Accepting new patients

Locations

2 Hot Metal St
#One
Pittsburgh, PA 15203
Phone (412) 432-5864

200 Lothrop St
Pittsburgh, PA 15213
Phone (412) 647-3553

815 Freeport Rd
Pittsburgh, PA 15215
Phone (412) 784-4000

520 E 6th St
Odessa, TX 79761
Phone (432) 332-0929

Organizations & group practices 4

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 1

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1164632402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 CIDERBERRY DR",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150906831",
            "telephone_number": "412-614-0797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 CIDERBERRY DR",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150906831",
            "telephone_number": "412-614-0797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2799 W Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482022608",
            "country_code": "US",
            "telephone_number": "313-916-8234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAKESH",
        "first_name": "HULIMANGALA",
        "middle_name": "RAJASEKHARAREDDY",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301083141",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD435081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wexford, PA

Sources for this page

Verify at the official NPI Registry.