NPIMap

Individual provider Active NPI

Indu Shivaram, MD

  • Internal Medicine Physician
  • Morehead, KY
National Provider Identifier
1194817619
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101265411 Issued in VA
Practice address
245 Flemingsburg Rd
Morehead, KY 40351-1015
Phone
(606) 780-5500
Fax
(606) 780-5512
NPI assigned
Sep 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 176776 NY
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 176776 NY
Pulmonary Disease Physician 207RP1001X 176776 NY
Internal Medicine Physician 207R00000X 0101265411 VA Primary

Addresses

Primary practice location

245 Flemingsburg Rd
Morehead, KY 40351-1015

Mailing address

245 Flemingsburg Rd
Morehead, KY 40351-1015
Phone (606) 780-5500

Other identifiers 2

IdentifierTypeStateIssuer
7100905520MedicaidKY
57647OtherKYMED LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, VA, KY3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20060224000642 NY Practitioner - Critical Care (Intensivists)Practitioner - Internal MedicinePractitioner - Pulmonary Disease 3678589884 Reassigns benefits to 2 organizations
I20191106002432 VA Practitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 3678589884 Reassigns benefits to 1 organization
I20230714002445 KY Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 3678589884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Claire Medical Center IncGroup PAC ID 4486559085, 181 clinicians

Practice addresses (Care Compare)

245 Flemingsburg Rd
Morehead, KY 40351-1015
Phone (606) 780-5500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
73.64 of 100Reported as group
Quality
56.63
Improvement activities
40
Cost
74.98

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
176776NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Westchester Medical Practice, PC CurrentSince Jan 1, 2018 Accepting new patients
St Claire Medical Center, Inc CurrentSince Jul 1, 2023 Accepting new patients
CMH Physician Services, LLC Internal Medicine CurrentSince Nov 1, 2019 Accepting new patients
Maimonides Medical Center Current Accepting new patients
Utopia Heartcare PLLC CurrentSince Nov 1, 2014 Accepting new patients
The Westchester Medical Practice, PC CurrentSince Jan 1, 2018 Accepting new patients
St Claire Medical Center, Inc., Internal Medicine CurrentSince Jul 1, 2023 Accepting new patients
CMH Physician Services, LLC CurrentSince Nov 1, 2019 Accepting new patients
St Claire Medical Center, Inc., Internal Medicine Current Accepting new patients

Locations

555 W Sun St
Morehead, KY 40351
Phone (606) 207-2931

222 Medical Cir
Morehead, KY 40351
Phone (606) 783-6455

245 Flemingsburg Rd
Morehead, KY 40351
Phone (606) 780-5500

1980 Crompond Rd
Cortlandt Mnr, NY 10567
Phone (914) 734-3600

21116 Union Tpke
Oakland Gdns, NY 11364
Phone (718) 217-0500

1755 N Mecklenburg Ave
South Hill, VA 23970
Phone (434) 584-2273

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: indushivaram@mai.allscriptsdirect.net

Organizations & group practices 9

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 4

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": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1194817619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 FLEMINGSBURG RD",
            "city": "MOREHEAD",
            "state": "KY",
            "postal_code": "403511015",
            "telephone_number": "606-780-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 FLEMINGSBURG RD",
            "city": "MOREHEAD",
            "state": "KY",
            "postal_code": "403511015",
            "telephone_number": "606-780-5500",
            "fax_number": "606-780-5512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIVARAM",
        "first_name": "INDU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "176776",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NY",
            "license": "176776",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "176776",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101265411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100905520",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MED LICENSE",
            "identifier": "57647",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morehead, KY

Sources for this page

Verify at the official NPI Registry.