NPIMap

Individual provider Active NPI

Lokender Bommisetty, MD

  • Diagnostic Radiology Physician
  • Fort Wayne, IN
National Provider Identifier
1225260342
Registry record updated Dec 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
01073618A Issued in IN
Practice address
3707 New Vision Dr
Fort Wayne, IN 46845-1702
Phone
(937) 829-8422
NPI assigned
Aug 24, 2009
Last updated
Dec 11, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MT197373 PA
Diagnostic Radiology Physician 2085R0202X 01073618A IN Primary

Addresses

Primary practice location

3707 New Vision Dr
Fort Wayne, IN 46845-1702

Mailing address

PO Box 709
Jasper, IN 47547-0709
Phone (937) 829-8422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, SD2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20141224001302 IN Practitioner - Diagnostic Radiology 2365669132 Reassigns benefits to 3 organizations
I20241208000023 SD Practitioner - Diagnostic Radiology 2365669132 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Ohio State University College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians
Avera MarshallGroup PAC ID 5799695227, 102 clinicians
Imaging Associates of Indiana PCGroup PAC ID 1254503345, 293 clinicians

Practice addresses (Care Compare)

1000 E 23Rd St
Sioux Falls, SD 57105-2134

1325 S Cliff Ave
Sioux Falls, SD 57105-1007

1606 N 7TH St
Terre Haute, IN 47804-2706
Phone (281) 870-4592

901 E Virgil Ave
Milbank, SD 57252-2124
Phone (605) 432-4538

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.04 of 100Reported as apm
Quality
89.99
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Merit-based Incentive Payment System (MIPS)

Final score
85.71 of 100Reported as group
Quality
85.75
Improvement activities
40
Cost
78.48

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT197373PAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Nov 1, 2024 Accepting new patients
Avera McKennan Diagnostic Radiology CurrentSince Nov 1, 2024 Accepting new patients
Avera Queen of Peace CurrentSince Nov 1, 2024 Accepting new patients
Avera Queen of Peace Current Accepting new patients
Avera Queen of Peace CurrentSince Nov 1, 2024 Accepting new patients
Avera Marshall CurrentSince Mar 10, 2025 Accepting new patients
Madison Community Hospital CurrentSince Feb 13, 2025 Accepting new patients
Avera McKennan Current Accepting new patients
Imaging Associates of Indiana, PC Diagnostic Radiology CurrentSince Aug 14, 2021 Accepting new patients
Breast Diagnostic Center, LLC Diagnostic Radiology CurrentSince Jan 1, 2015 Accepting new patients
Madison Community Hospital CurrentSince Feb 13, 2025 Accepting new patients
Avera Marshall CurrentSince Mar 10, 2025 Accepting new patients
Summit Radiology P C Diagnostic Radiology Past Accepting new patients

Locations

1201 S Main St
Crown Point, IN 46307
Phone (219) 738-2100

11109 Parkview Plaza Dr
Fort Wayne, IN 46845
Phone (260) 266-2020

1818 Carew St
Ste 30
Fort Wayne, IN 46805
Phone (260) 425-5900

1818 Carew St
Ste 40
Fort Wayne, IN 46805
Phone (219) 483-1847

2110 Carew St
Fort Wayne, IN 46805
Phone (219) 432-6710

3707 New Vision Dr
Fort Wayne, IN 46845
Phone (260) 373-4000

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

323 SW 10th St
Madison, SD 57042
Phone (605) 256-6551

525 N Foster St
Mitchell, SD 57301
Phone (605) 995-2000

1325 S Cliff Ave
Sioux Falls, SD 57105
Phone (605) 322-5000

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1251072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481414400000",
    "number": "1225260342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 709",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475470709",
            "telephone_number": "937-829-8422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 NEW VISION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451702",
            "telephone_number": "937-829-8422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMMISETTY",
        "first_name": "LOKENDER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-24",
        "last_updated": "2016-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MT197373",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01073618A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.