Individual provider Active NPI

Koteswara R. Nalluri, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Delaware, OH
National Provider Identifier
1396715439
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
35.076225 Issued in OH
Practice address
561 W Central Ave
Delaware, OH 43015-1410
Phone
(740) 615-1000
Fax
(740) 615-2142
NPI assigned
Jan 23, 2006
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
Pain Medicine (Anesthesiology) Physician 207LP2900X 35.076225 OH Primary

Addresses

Primary practice location

561 W Central Ave
Delaware, OH 43015-1410

Mailing address

5450 Frantz Rd Ste 360
Dublin, OH 43016-4141
Phone (419) 520-2495

Other identifiers 1

IdentifierTypeStateIssuer
2125060MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address knalluri354338@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: 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
I20130204000390 OH Practitioner - AnesthesiologyPractitioner - Pain Management 5092969840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians

Practice addresses (Care Compare)

561 W Central Ave
Delaware, OH 43015-1410
Phone (614) 566-9143

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.04 of 100Reported as group
Quality
58.67
Promoting interoperability
98
Improvement activities
40
Cost
76.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.076225OHMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Jul 1, 2019 Accepting new patients
Ohiohealth Corporation Pain Medicine CurrentSince Jul 1, 2019 Accepting new patients

Locations

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

793 W State St
Columbus, OH 43222
Phone (614) 234-1862

Dept L3652
Columbus, OH 43260

561 W Central Ave
Delaware, OH 43015
Phone (614) 566-9983

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

500 S Cleveland Ave
Westerville, OH 43081
Phone (380) 898-4000

Interoperability endpoints

  • Direct secure messaging: knalluri354338@direct.ohiohealth.com

Organizations & group practices 2

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 3

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": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1396715439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 FRANTZ RD STE 360",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430164141",
            "telephone_number": "419-520-2495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "561 W CENTRAL AVE",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430151410",
            "telephone_number": "740-615-1000",
            "fax_number": "740-615-2142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NALLURI",
        "first_name": "KOTESWARA",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "OH",
            "license": "35.076225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2125060",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "knalluri354338@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group",
            "address_1": "561 W Central Ave",
            "city": "Delaware",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430151410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Delaware, OH

Sources for this page

Verify at the official NPI Registry.