Rahul Kodali, M.D

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD460750 Issued in PA

Practice address

210 Sunbury St
Minersville, PA 17954-1346

Phone

(570) 544-9123

Fax

(570) 544-9263

NPI assigned

Jul 8, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rahulkodali@primaryhn.medalliesdirect.net

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.

• Primary Health Network

  • Federally Qualified Health Center (FQHC)
  • Sharon, PA
  • NPI 1417932609
  Medicare reassignment NPD
• Primary Health Network

  • Federally Qualified Health Center (FQHC)
  • Emlenton, PA
  • NPI 1750181038
  NPD

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

{
    "created_epoch": "1341705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1356606164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SHENANGO AVE",
            "city": "SHARON",
            "state": "PA",
            "postal_code": "161461503",
            "telephone_number": "570-544-9123",
            "fax_number": "570-544-9263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 SUNBURY ST",
            "city": "MINERSVILLE",
            "state": "PA",
            "postal_code": "179541346",
            "telephone_number": "570-544-9123",
            "fax_number": "570-544-9263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KODALI",
        "first_name": "RAHUL",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-08",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD460750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hershey Dental Associates LLC (Buehner Family Dental Care)
• Crystal S Hoffmaster
• Christine Marie Hunyara, PA-C
• Lisa Jack
• Christine Keefer
• Michael R Kudryk, DMD
• Carolyn Kushwarra, RPH
• Erika Ledezma
• Cynthia L Lubinsky, DO
• Ellen NMN Mace, DO

• Psychiatry Physician in Minersville, PA
• Providers in Minersville, PA by specialty
• Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; 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.