Individual provider Active NPI

Gowri Radhakrishnan, MD

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1346504446
Registry record updated Apr 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
15820 Issued in NV
Practice address
2040 W Charleston Blvd Ste 300
Department of Internal Medicine
Las Vegas, NV 89102-2244
Phone
(702) 671-2345
Fax
(702) 671-2376
NPI assigned
Jul 3, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 15820 NV Primary

Addresses

Primary practice location

2040 W Charleston Blvd Ste 300
Department of Internal Medicine
Las Vegas, NV 89102-2244

Mailing address

2040 W Charleston Blvd Ste 300
Department of Internal Medicine
Las Vegas, NV 89102-2244
Phone (702) 671-2345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20210802001885 FL Practitioner - Internal Medicine 5395051106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

86 W Underwood St
Orlando, FL 32806-1110
Phone (407) 896-1100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Aug 15, 2021 Accepting new patients
Orlando Health, Inc. Current Accepting new patients
Orlando Health Medical Group Inc Internal Medicine CurrentSince Aug 15, 2021 Accepting new patients

Locations

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

86 Underwood St
Orlando, FL 32806
Phone (321) 841-5142

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: gradhakrishnan282646@orlandohealth.medalliesdirect.net

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.

Hospital & facility affiliations 1

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": "1341273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554249600000",
    "number": "1346504446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 W CHARLESTON BLVD STE 300",
            "address_2": "DEPARTMENT OF INTERNAL MEDICINE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022244",
            "telephone_number": "702-671-2345",
            "fax_number": "702-671-2376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 W CHARLESTON BLVD STE 300",
            "address_2": "DEPARTMENT OF INTERNAL MEDICINE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022244",
            "telephone_number": "702-671-2345",
            "fax_number": "702-671-2376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADHAKRISHNAN",
        "first_name": "GOWRI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-03",
        "last_updated": "2019-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "15820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.