NPIMap

Individual provider Active NPI

Vamsee K Amirneni, MD

  • Internal Medicine Physician
  • Ontario, OH
National Provider Identifier
1346400058
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35090648 Issued in OH
Practice address
1750 W 4TH St
Ontario, OH 44906-1770
Phone
(419) 520-3530
Fax
(419) 520-3531
NPI assigned
Jun 16, 2008
Last updated
Jan 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35090648 OH Primary

Addresses

Primary practice location

1750 W 4TH St
Ontario, OH 44906-1770

Mailing address

335 Glessner Ave
Mansfield, OH 44903-2269
Phone (419) 520-2495

Other identifiers 1

IdentifierTypeStateIssuer
2843187MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vamirneni134332@direct.ohiohealth.com OhioHealth Physician Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20080731000085 OH Practitioner - Internal Medicine 1254405889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians

Practice addresses (Care Compare)

1750 W 4TH St
Ontario, OH 44906-1770
Phone (567) 309-9550

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35090648OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Jan 1, 2021 Accepting new patients
Ohiohealth Corporation CurrentSince Jan 1, 2021 Accepting new patients
Ohiohealth Corporation Internal Medicine Current Accepting new patients
Medcentral Professional Association Inc. Past Accepting new patients

Locations

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

Dept L3652
Columbus, OH 43260

5450 Frantz Rd
Ste 360
Dublin, OH 43016
Phone (614) 533-6497

335 Glessner Ave
Mansfield, OH 44903
Phone (419) 522-0320

1750 W 4th St
Ontario, OH 44906
Phone (419) 520-3530

Interoperability endpoints

  • Direct secure messaging: vamirneni134332@direct.ohiohealth.com

Organizations & group practices 4

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 10

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": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1346400058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 GLESSNER AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449032269",
            "telephone_number": "419-520-2495",
            "fax_number": "419-520-2565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 W 4TH ST",
            "city": "ONTARIO",
            "state": "OH",
            "postal_code": "449061770",
            "telephone_number": "419-520-3530",
            "fax_number": "419-520-3531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMIRNENI",
        "first_name": "VAMSEE",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-16",
        "last_updated": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35090648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2843187",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vamirneni134332@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group",
            "address_1": "1750 W 4th St",
            "city": "Ontario",
            "state": "OH",
            "country_code": "US",
            "postal_code": "449061770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ontario, OH

Sources for this page

Verify at the official NPI Registry.