Individual provider Active NPI

Nagarjuna R Ponugoti, M.D

  • Allergy Physician
  • Terre Haute, IN
National Provider Identifier
1285601278
Registry record updated Nov 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
01040096 Issued in IN
Practice address
4779 S 7TH St
Terre Haute, IN 47802-4559
Phone
(812) 234-2016
Fax
(812) 234-2700
NPI assigned
Mar 8, 2006
Last updated
Nov 8, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X 01040096 IN Primary

Addresses

Primary practice location

4779 S 7TH St
Terre Haute, IN 47802-4559

Mailing address

4779 S 7TH St
Terre Haute, IN 47802-4559
Phone (812) 234-2016

Other identifiers 1

IdentifierTypeStateIssuer
100252770AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20111011000633 IN Practitioner - Allergy/Immunology 9830361070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4779 S 7TH St
Terre Haute, IN 47802-4559
Phone (812) 234-2016

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy Asthma and Immunology Associates of TH LLC CurrentSince Feb 26, 2001 Accepting new patients
Nutrition Center for Disease and Weight Management CurrentSince Jun 12, 2017 Accepting new patients

Locations

4779 S 7th St
Terre Haute, IN 47802
Phone (812) 234-2016

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 2

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": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478563200000",
    "number": "1285601278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4779 S 7TH ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478024559",
            "telephone_number": "812-234-2016",
            "fax_number": "812-234-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4779 S 7TH ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478024559",
            "telephone_number": "812-234-2016",
            "fax_number": "812-234-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONUGOTI",
        "first_name": "NAGARJUNA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2016-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "IN",
            "license": "01040096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100252770A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

Verify at the official NPI Registry.