NPIMap

Individual provider Active NPI

Krishna Komanduri, D.O

  • Nephrology Physician
  • Pottstown, PA
National Provider Identifier
1295093466
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
OS018815 Issued in PA
Practice address
1591 Medical Dr
Pottstown, PA 19464-3224
Phone
(610) 326-8005
Fax
(610) 705-3540
NPI assigned
Apr 25, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X OS018815 PA Primary

Addresses

Primary practice location

1591 Medical Dr
Pottstown, PA 19464-3224

Mailing address

609 W Germantown Pike Ste 210
East Norriton, PA 19403-4251
Phone (610) 649-1175

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kkomanduri16389@direct.acumenmd.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170731000441 PA Practitioner - Nephrology 8426296781 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kidney Care Specialists LLCGroup PAC ID 9931450079, 41 clinicians

Practice addresses (Care Compare)

609 W Germantown Pike
Suite 210
East Norriton, PA 19403-4251
Phone (610) 649-1175

Hospital & facility affiliations

  • USRC Pottstown Dialysis facility, Pottstown, PA, CCN 392707
  • FKC Pottstown Dialysis facility, Pottstown, PA, CCN 392802
  • Pottstown Hospital Hospital, Pottstown, PA, CCN 390123
  • Phoenixville Hospital Hospital, Phoenixville, PA, CCN 390127
  • Reading Hospital Hospital, West Reading, PA, CCN 390044
  • Jefferson Einstein Montgomery Hospital Hospital, East Norriton, PA, CCN 390329
  • Paoli Hospital Hospital, Paoli, PA, CCN 390153

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS018815PAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kidney Care Specialists LLC Nephrology CurrentSince Apr 1, 2021 Accepting new patients

Locations

1230 S Cedar Crest Blvd
Ste 301
Allentown, PA 18103
Phone (610) 432-4873

2000 Sproul Rd
Ste 300
Broomall, PA 19008
Phone (610) 356-3700

609 W Germantown Pike
Ste 210
Norristown, PA 19403
Phone (610) 275-2446

1105 Bethlehem Pike
#B5
Sellersville, PA 18960
Phone (215) 257-4533

Organizations & group practices 1

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1295093466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 W GERMANTOWN PIKE STE 210",
            "city": "EAST NORRITON",
            "state": "PA",
            "postal_code": "194034251",
            "telephone_number": "610-649-1175",
            "fax_number": "610-279-4841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1591 MEDICAL DR",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194643224",
            "telephone_number": "610-326-8005",
            "fax_number": "610-705-3540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMANDURI",
        "first_name": "KRISHNA",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-25",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "OS018815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkomanduri16389@direct.acumenmd.com",
            "affiliation": "N",
            "address_1": "609 W Germantown Pike Ste 210",
            "city": "East Norriton",
            "state": "PA",
            "country_code": "US",
            "postal_code": "194034251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pottstown, PA

Sources for this page

Verify at the official NPI Registry.