Individual provider Active NPI

Raksha Prakash Indorkar, M.D.

  • Cardiovascular Disease Physician
  • Cleveland, OH
National Provider Identifier
1225355167
Registry record updated Jun 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036138115 Issued in IL
Practice address
11100 Euclid Ave
University Hospitals Case Medical Center
Cleveland, OH 44106
Phone
(216) 844-8500
NPI assigned
May 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2023

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 35-121505 OH
Cardiovascular Disease Physician 207RC0000X 036138115 IL Primary

Addresses

Primary practice location

11100 Euclid Ave
University Hospitals Case Medical Center
Cleveland, OH 44106

Mailing address

Division of Cardiology
840 S Wood Street, CSB 920 (MC 715)
Chicago, IL 60612
Phone (213) 996-9086

Other identifiers 1

IdentifierTypeStateIssuer
0086372MedicaidOH

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
I20180807001355 IL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 5193966067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

1401 E 12TH St
Mendota, IL 61342-9216
Phone (815) 227-5600

444 Roxbury Rd
Rockford, IL 61107-5059
Phone (815) 398-3000

5666 E State St
Rockford, IL 61108-2425
Phone (815) 921-8929

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

900 N 2ND St
Rochelle, IL 61068-1764
Phone (815) 677-8833

Hospital & facility affiliations

  • Saint Anthony Medical Center Hospital, Rockford, IL, CCN 140233
  • Rochelle Community Hospital Hospital, Rochelle, IL, CCN 141312
  • Osf Saint Paul Medical Center Hospital, Mendota, IL, CCN 141310
  • Osf Saint Elizabeth MDL Ctr Hospital, Peru, IL, CCN 140110
  • Osf Saint Katharine Medical Center Hospital, Dixon, IL, CCN 140012

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-121505OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group Internal Medicine CurrentSince Sep 1, 2018 Accepting new patients

Locations

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

444 Roxbury Rd
Rockford, IL 61107
Phone (815) 395-9196

444 Roxbury Rd
#12471
Rockford, IL 61107

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1272844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687564800000",
    "number": "1225355167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DIVISION OF CARDIOLOGY",
            "address_2": "840 S WOOD STREET, CSB 920 (MC 715)",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "213-996-9086",
            "fax_number": "312-413-2948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 EUCLID AVE",
            "address_2": "UNIVERSITY HOSPITALS CASE MEDICAL CENTER",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44106",
            "telephone_number": "216-844-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INDORKAR",
        "first_name": "RAKSHA",
        "middle_name": "PRAKASH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-03",
        "last_updated": "2023-06-24",
        "certification_date": "2023-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-121505",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036138115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0086372",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.