Ravindhra G Elluru, MD, PHD

Primary specialty

Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X

License

01094488A Issued in IN

Practice address

8402 Harcourt Rd Ste 400
Indianapolis, IN 46260-2053

Phone

(317) 338-6815

NPI assigned

Jul 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in OH, IN, WI3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ravindhra.elluru.1@7598.direct.athenahealth.com

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.

• St Vincent Pediatric Subspecialties

  • Pediatrics Physician
  • Indianapolis, IN
  • NPI 1013967736

  Pediatric Otolaryngology

  Medicare reassignment NPD
• Dayton Children'S Specialty Physicians, Inc.

  • Pediatrics Physician
  • Dayton, OH
  • NPI 1225192610
  Medicare reassignment NPD
• University of Wisconsin Medical Foundation, Inc

  • Multi-Specialty Clinic/Center
  • Middleton, WI
  • NPI 1598784555
  Medicare reassignment NPD
• St Vincent Pediatric Subspecialties

  • Pediatric Critical Care Medicine Physician
  • Evansville, IN
  • NPI 1851950224
  NPD
• Dayton Children'S Specialty Physicians, Inc.

  • Pediatrics Physician
  • Dayton, OH
  • NPI 1780467555
  NPD
• University of Wisconsin Medical Foundation, Inc

  • Health Educator
  • Madison, WI
  • NPI 1487414082
  NPD
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1356361968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8402 HARCOURT RD STE 400",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8402 HARCOURT RD STE 400",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602053",
            "telephone_number": "317-338-6815"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1675 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537921815",
            "country_code": "US",
            "telephone_number": "608-263-6420",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8402 Harcourt Rd Ste 731",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462602056",
            "country_code": "US",
            "telephone_number": "317-338-6815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLURU",
        "first_name": "RAVINDHRA",
        "middle_name": "G",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "OH",
            "license": "35.079575",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "WI",
            "license": "102056-875",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "IN",
            "license": "01094488A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2377888",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ravindhra.elluru.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St Vincent Pediatric Subspecialties",
            "address_1": "8402 Harcourt Rd Ste 400",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462602053",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "relluru4958754@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "1675 Highland Ave",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537921815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Teylor N Ellis, PA-C
• Wayne M. Ellis, MD
• Kaysee Mae Ellrich, OTR
• Cierra Ellson
• Susannah G Ellsworth, MD
• Mary Elmasry, DDS
• Rose Laure Elmond
• Eboni Elmore
• Laurie Elmore, RD
• Michael Francis Elmore, M.D.

• Pediatric Otolaryngology Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Pediatric Otolaryngology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.