NPIMap

Individual provider Active NPI

Sangeeta Laxmi Guttikonda

  • Diagnostic Radiology Physician
  • Indianapolis, IN
National Provider Identifier
1295956662
Registry record updated Jun 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
01059508 Issued in IN
Practice address
714 N Senate Ave
Ste 100
Indianapolis, IN 46202-3763
Phone
(317) 715-6402
Fax
(317) 715-6415
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2011

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 35.078109 OH
Diagnostic Radiology Physician 2085R0202X 01059508 IN Primary

Addresses

Primary practice location

714 N Senate Ave
Ste 100
Indianapolis, IN 46202-3763

Mailing address

714 N Senate Ave
Ste 100
Indianapolis, IN 46202-3763
Phone (317) 715-6402

Other identifiers 2

IdentifierTypeStateIssuer
200491260MedicaidIN
P00800392OtherINRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.078109OHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Radiologists Inc Diagnostic Radiology Past Accepting new patients
Osu Radiology LLC Diagnostic Radiology PastSince Oct 1, 2005 Accepting new patients
Medical Scanning Consultants PA Diagnostic Radiology Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sguttiko@direct.iuhealth.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307923200000",
    "number": "1295956662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 N SENATE AVE",
            "address_2": "STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462023763",
            "telephone_number": "317-715-6402",
            "fax_number": "317-715-6415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 N SENATE AVE",
            "address_2": "STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462023763",
            "telephone_number": "317-715-6402",
            "fax_number": "317-715-6415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTTIKONDA",
        "first_name": "SANGEETA",
        "middle_name": "LAXMI",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2011-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35.078109",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01059508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200491260",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00800392",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.