Individual provider Active NPI

Kuppuswamy Jagarlamudi, M.D.

  • Hematology & Oncology Physician
  • Mattoon, IL
National Provider Identifier
1194995357
Registry record updated Jul 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
036-128607 Issued in IL
Practice address
1000 Health Center Dr
Mattoon, IL 61938-9253
Phone
(217) 258-2250
Fax
(217) 258-2249
NPI assigned
Mar 4, 2008
Last updated
Jul 26, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 247809 NY
Hematology & Oncology Physician 207RH0003X 036-128607 IL Primary

Addresses

Primary practice location

1000 Health Center Dr
Mattoon, IL 61938-9253

Mailing address

1000 Health Center Dr
Mattoon, IL 61938-9253
Phone (217) 258-2250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20110805000499 IL Practitioner - Hematology/Oncology 4284803370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sarah Bush Lincoln Health CenterGroup PAC ID 5092614867, 411 clinicians

Practice addresses (Care Compare)

1000 Health Ctr Dr
Mattoon, IL 61938-4644
Phone (217) 258-2525

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.96 of 100Reported as apm
Quality
69.5
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
247809NYMDInternal Medicine Physician
036-128607ILMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sarah Bush Lincoln Health Center CurrentSince Jul 25, 2011 Accepting new patients
Sarah Bush Lincoln Health Center CurrentSince Jul 25, 2011 Accepting new patients

Locations

1000 Health Center Dr
Mattoon, IL 61938
Phone (217) 258-2389

1000 Health Center Dr
Ste 401
Mattoon, IL 61938
Phone (217) 258-2409

101 Professional Plz
Mattoon, IL 61938
Phone (217) 238-3730

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, 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": "1204588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311638400000",
    "number": "1194995357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HEALTH CENTER DR",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619389253",
            "telephone_number": "217-258-2250",
            "fax_number": "217-258-2249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HEALTH CENTER DR",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619389253",
            "telephone_number": "217-258-2250",
            "fax_number": "217-258-2249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGARLAMUDI",
        "first_name": "KUPPUSWAMY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-04",
        "last_updated": "2011-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "247809",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IL",
            "license": "036-128607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattoon, IL

Sources for this page

Verify at the official NPI Registry.