Individual provider Active NPI

Radha Vanukuri, MD

  • Hospitalist Physician
  • Thibodaux, LA
National Provider Identifier
1316131196
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
036144685 Issued in IL
Practice address
931 North Canal Blvd
Thibodaux, LA 70301
Phone
(985) 446-6381
Fax
(985) 446-5992
NPI assigned
Sep 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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 MD.204091 LA
Hospitalist Physician 208M00000X 036144685 IL Primary

Addresses

Primary practice location

931 North Canal Blvd
Thibodaux, LA 70301

Mailing address

931 North Canal Blvd
Thibodaux, LA 70301
Phone (985) 446-6381

Other identifiers 1

IdentifierTypeStateIssuer
1007455MedicaidLA

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
I20171220000383 IL Practitioner - HospitalistPractitioner - Internal Medicine 8729260203 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Saint Anthonys Way
Alton, IL 62002-4568
Phone (618) 465-2571

1 Saint Elizabeth Blvd
O Fallon, IL 62269-1099
Phone (618) 234-2120

2200 E Washington St
Bloomington, IL 61701-4364
Phone (309) 662-5361

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Illinois Hospitalists, LLP Internal Medicine CurrentSince Jul 20, 2025 Accepting new patients
Cep America-Illinois Hospitalists Hospitalist CurrentSince Jul 20, 2025 Accepting new patients
Osf Multi-Specialty Group Internal Medicine CurrentSince Jan 2, 2018 Accepting new patients
Cep America-Illinois Hospitalists, LLP Internal Medicine Current Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

4500 Memorial Dr
Belleville, IL 62226
Phone (618) 233-7750

1505 Eastland Dr
Ste 320
Bloomington, IL 61701
Phone (309) 661-2368

1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438

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

Organizations & group practices 5

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": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1316131196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 NORTH CANAL BLVD",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "70301",
            "telephone_number": "985-446-6381",
            "fax_number": "985-446-5992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 NORTH CANAL BLVD",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "70301",
            "telephone_number": "985-446-6381",
            "fax_number": "985-446-5992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANUKURI",
        "first_name": "RADHA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-05",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "MD.204091",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036144685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007455",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thibodaux, LA

Sources for this page

Verify at the official NPI Registry.