Individual provider Active NPI

Raghu Maddela, MD, MPH

  • Physical Medicine & Rehabilitation Physician
  • Indianapolis, IN
National Provider Identifier
1477718781
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
01079040A Issued in IN
Practice address
1400 N Ritter Ave Ste 479
Indianapolis, IN 46219-3050
Phone
(317) 355-1470
NPI assigned
Jul 25, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 01079040A IN Primary

Addresses

Primary practice location

1400 N Ritter Ave Ste 479
Indianapolis, IN 46219-3050

Mailing address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890

Other practice location 1

25 Prospect Ave
Hackensack, NJ 07601-1960
Phone (201) 343-2277 ext. 5

Other identifiers 1

IdentifierTypeStateIssuer
273892132OtherNJTAX ID

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rmaddela287478@eCommunityDirect.com Community Physicians of Indiana Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20171129000832 IN Practitioner - Physical Medicine and Rehabilitation 6608176904 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
West Virginia University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

1400 N Ritter Ave
Suite 479
Indianapolis, IN 46219-3050
Phone (317) 355-1470

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Dec 4, 2017 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Dec 4, 2017 Accepting new patients
Major Hospital Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

5445 E 16th St
Indianapolis, IN 46218
Phone (317) 355-4358

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

1400 N Ritter Ave
Ste 479
Indianapolis, IN 46219
Phone (317) 355-1020

1550 E County Line Rd
Ste 201
Indianapolis, IN 46227

1400 N Ritter Ave
Indianapolis, IN 46219
Phone (317) 355-1111

Interoperability endpoints

  • Direct secure messaging: rmaddela287478@ecommunitydirect.com

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 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": "1216944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1477718781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N RITTER AVE STE 479",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462193050",
            "telephone_number": "317-355-1470"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Prospect Ave",
            "address_purpose": "LOCATION",
            "city": "Hackensack",
            "state": "NJ",
            "postal_code": "076011960",
            "country_code": "US",
            "telephone_number": "201-343-2277 x5",
            "fax_number": "201-343-7410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MADDELA",
        "first_name": "RAGHU",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-25",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IN",
            "license": "01079040A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "273892132",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmaddela287478@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "1400 N Ritter Ave Ste 479",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462193050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.