Tariku Tadele Gudura, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

MD484066 Issued in PA

Practice address

17 Arentzen Blvd Ste 204
Charleroi, PA 15022-1085

Phone

(724) 489-0220

Fax

(724) 489-0855

NPI assigned

Jun 14, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IN, IL, PA, OH4 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 4

Specialty

NephrologyAlso: Internal Medicine

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Pittsburgh Kidney Care LLCGroup PAC ID 1658664578, 15 clinicians

Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cleveland Clinic Hospital, Cleveland, OH, CCN 360180
• Jefferson Hospital Hospital, Jefferson Hills, PA, CCN 390265
• Uniontown Hospital Hospital, Uniontown, PA, CCN 390041
• Akron General Medical Center Hospital, Akron, OH, CCN 360027
• Hillcrest Hospital Hospital, Mayfield Heights, OH, CCN 360230

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tgudura62161@direct.acumenmd.com
• FHIR API: https://api.platform.athenahealth.com/14360/brand/23/csg/1/fhir/r4
• Direct secure messaging: tgudura@direct.iuhealth.org

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.

• Pittsburgh Kidney Care LLC

  • Nephrology Physician
  • Clairton, PA
  • NPI 1699122069
  Medicare reassignment Care Compare group NPD
• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Medicare reassignment Care Compare group NPD
• Central Dupage Physician Group

  • Family Medicine Physician
  • Carol Stream, IL
  • NPI 1033149844

  Internal Medicine

  Medicare reassignment NPD
• Iu Health Medical Group, LLC

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1326893777
  Medicare reassignment NPD
• University Family Physicians, Inc.

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1043275787

  Internal Medicine

  Medicare reassignment NPD
• Central Dupage Physician Group

  • Orthopaedic Surgery Physician
  • Geneva, IL
  • NPI 1780012344
  NPD
• University Family Physicians, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Indianapolis, IN
  • NPI 1669828042
  NPD

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

• Jefferson Regional Medical Center

  • Clinic/Center
  • Clairton, PA
  • NPI 1366488108

  Hospital

  Care Compare affiliation
• Jefferson Regional Medical Center

  • General Acute Care Hospital
  • Clairton, PA
  • NPI 1578560504
  Care Compare affiliation
• Uniontown Hospital

  • Clinic/Center
  • Uniontown, PA
  • NPI 1225045131

  Hospital

  Care Compare affiliation
• Uniontown Hospital

  • Internal Medicine Physician
  • Uniontown, PA
  • NPI 1245488048

  Hospital

  Care Compare affiliation
• Uniontown Hospital

  • Institutional Pharmacy
  • Uniontown, PA
  • NPI 1801910989

  Hospital

  Care Compare affiliation
• Uniontown Hospital

  • General Acute Care Hospital
  • Uniontown, PA
  • NPI 1861409773
  Care Compare affiliation
• Uniontown Hospital

  • General Acute Care Hospital
  • Uniontown, PA
  • NPI 1871594127
  Care Compare affiliation
• Akron General Medical Center

  • General Acute Care Hospital
  • Akron, OH
  • NPI 1821035940
  Care Compare affiliation
• Cleveland Clinic Health System - East Region

  • General Acute Care Hospital
  • Mayfield HTS, OH
  • NPI 1902858152
  Care Compare affiliation
• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Care Compare affiliation

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1255861001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 COAL VALLEY RD STE 204",
            "city": "CLAIRTON",
            "state": "PA",
            "postal_code": "150253724",
            "telephone_number": "412-466-2220",
            "fax_number": "412-466-4048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 ARENTZEN BLVD STE 204",
            "city": "CHARLEROI",
            "state": "PA",
            "postal_code": "150221085",
            "telephone_number": "724-489-0220",
            "fax_number": "724-489-0855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 N Senate Blvd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462021239",
            "country_code": "US",
            "telephone_number": "317-962-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "575 Coal Valley Rd Ste 204",
            "address_purpose": "LOCATION",
            "city": "Clairton",
            "state": "PA",
            "postal_code": "150253724",
            "country_code": "US",
            "telephone_number": "724-489-0220",
            "fax_number": "412-466-4048",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUDURA",
        "first_name": "TARIKU",
        "middle_name": "TADELE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-14",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.070266",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01084186A",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036152123",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "MD484066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043201090001",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tgudura@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "1701 N Senate Blvd",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021239",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tgudura62161@direct.acumenmd.com",
            "affiliation": "N",
            "address_1": "17 Arentzen Blvd Ste 204",
            "city": "Charleroi",
            "state": "PA",
            "country_code": "US",
            "postal_code": "150221085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• George M Toohey OD
• Angela Getto
• Alyssa Marie Gibino, PA-C
• William Sean Gillott, D.C.
• Lawrence Laray Gipson, M.D.
• Nancy L. Hager, MS, SLP-CCC
• Mickael Hanon, DPT
• Kelsey Harbold, DPT
• HCBR LLC Tenth Street Pharmacy
• Diana Heinbaugh, MS, OTR/L

• Nephrology Physician in Charleroi, PA
• Providers in Charleroi, PA by specialty
• Nephrology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; 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.