Gautham Reddy Kandukuri, M.D.

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

MD211277 Issued in OR

Practice address

PO Box 343
Reedsport, OR 97467-0343

Phone

(816) 800-9020

NPI assigned

May 5, 2016

Last updated

May 15, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR, KS, NJ, TX, FL, MI, MT, UT8 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 8

Specialty

Diagnostic Radiology

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Inspire Radiology Group 2 LLCGroup PAC ID 1355870460, 23 clinicians

Inspire Radiology Group LLCGroup PAC ID 2365975216, 15 clinicians

Gonzales Healthcare SystemsGroup PAC ID 8527963776, 35 clinicians

University of Florida Jacksonville Physicians, Inc.Group PAC ID 9133025869, 908 clinicians

McLaren Hospital GroupGroup PAC ID 2365968351, 366 clinicians

Kane County Human Resource Special Service DistrictGroup PAC ID 5092603316, shared by 8 NPIs, 36 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bay Area Hospital Hospital, Coos Bay, OR, CCN 380090
• Shands Jacksonville Hospital, Jacksonville, FL, CCN 100001
• Ed Fraser Memorial Hospital Hospital, Macclenny, FL, CCN 100134
• McKenzie-Willamette Medical Center Hospital, Springfield, OR, CCN 380020
• McLaren Bay Region Hospital, Bay City, MI, CCN 230041

Merit-based Incentive Payment System (MIPS)

Final score

87.45 of 100Reported as group

Quality

69.6

Promoting interoperability

100

Improvement activities

40

Cost

76.59

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gkandukuri816139@direct.shands.ufl.edu
• Direct secure messaging: gkandukuri818097@direct.shands.ufl.edu
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Inspire Radiology Group 2 LLC

  • Diagnostic Radiology Physician
  • Coos Bay, OR
  • NPI 1396570644

  MI, NJ, TX, Vascular & Interventional Radiology

  Medicare reassignment Care Compare group NPD
• Inspire Radiology Group LLC

  • Diagnostic Radiology Physician
  • Coos Bay, OR
  • NPI 1487485181

  FL, MI, NJ, TX, Vascular & Interventional Radiology

  Medicare reassignment Care Compare group NPD
• Gonzales Healthcare Systems

  dba Sievers Medical Clinic

  • Rural Health Clinic/Center
  • Gonzales, TX
  • NPI 1013916287
  Medicare reassignment Care Compare group NPD
• University of Florida Jacksonville Physicians, Inc.

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1144276452
  Medicare reassignment Care Compare group NPD
• Bay Area Hospital District

  dba Bay Area Hospital

  • General Acute Care Hospital
  • Coos Bay, OR
  • NPI 1225016561
  Medicare reassignment NPD
• Lower Umpqua Hospital District

  • Critical Access Hospital
  • Reedsport, OR
  • NPI 1003874819
  Medicare reassignment NPD
• Castro County Hospital District

  dba Plains Memorial Hospital

  • Critical Access Hospital
  • Dimmitt, TX
  • NPI 1033118716
  Medicare reassignment NPD
• Castro County Hospital District

  dba Plains Memorial Hospital

  • Emergency Care Clinic/Center
  • Dimmitt, TX
  • NPI 1891828059
  Medicare reassignment NPD
• Kane County Human Resource Special Service District

  dba Kane County Hospital

  • General Acute Care Hospital
  • Kanab, UT
  • NPI 1043380991
  Medicare reassignment NPD
• Kane County Human Resource Special Service District

  dba Kane County Medical Clinic

  • Family Medicine Physician
  • Kanab, UT
  • NPI 1215001037
  Medicare reassignment NPD
• McKenzie Physician Services LLC

  • General Practice Physician
  • Brentwood, TN
  • NPI 1316909054

  OR

  Medicare reassignment NPD
• Minneola District Hospital NBR 2

  • Critical Access Hospital
  • Minneola, KS
  • NPI 1013009828
  Medicare reassignment NPD

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

• Bay Area Hospital District

  dba Bay Area Hospital

  • General Acute Care Hospital
  • Coos Bay, OR
  • NPI 1225016561
  Care Compare affiliation
• McKenzie-Willamette Regional Medical Center Associates LLC

  dba McKenzie-Willamette Medical Center

  • General Acute Care Hospital
  • Springfield, OR
  • NPI 1568413573
  Care Compare affiliation
• Baker County Medical Services Inc

  • Rural Acute Care Hospital
  • Macclenny, FL
  • NPI 1104926401
  Care Compare affiliation
• McLaren Bay Region

  • General Acute Care Hospital
  • Bay City, MI
  • NPI 1528031226
  Care Compare affiliation
• Shands Jacksonville Medical Center Inc

  • Urgent Care Clinic/Center
  • Jacksonville, FL
  • NPI 1144962408

  Hospital

  Care Compare affiliation
• Shands Jacksonville Medical Center Inc

  dba Shands Jacksonville

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1821186313
  Care Compare affiliation

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

{
    "created_epoch": "1462406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1174979462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 HOLMES STREET",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "64108",
            "telephone_number": "816-404-4175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 343",
            "city": "REEDSPORT",
            "state": "OR",
            "postal_code": "974670343",
            "telephone_number": "816-800-9020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1775 Thompson Rd",
            "address_purpose": "LOCATION",
            "city": "Coos Bay",
            "state": "OR",
            "postal_code": "974202198",
            "country_code": "US",
            "telephone_number": "541-269-8111",
            "fax_number": "541-269-8517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANDUKURI",
        "first_name": "GAUTHAM",
        "middle_name": "REDDY",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-05",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "UT",
            "license": "14217294-1205",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "OR",
            "license": "MD211277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Stephen Jany, MD
• Jennifer Rossi PHD PC
• Shynar Johnson, PA-C
• John William Jones
• Sarah M Jones, PA
• Robert D Law, MD
• Kenneth Lee Lawson, MD
• Lower Umpqua Hospital District
• Lower Umpqua Hospital District
• Lower Umpqua Hospital District (Lower Umpqua Hospital Pharmacy)

• Vascular & Interventional Radiology Physician in Reedsport, OR
• Providers in Reedsport, OR by specialty
• Vascular & Interventional Radiology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; 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.