Active NPI
Krishna Chaitanya Cherukuri, M.D.
- Interventional Cardiology Physician
- Carbondale, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Cardiology Physician
- License
- 036153082
- Practice address
- 409 W Oak St
Carbondale, IL 62901-1464 - Phone
- (618) 529-4455
- Fax
- (618) 351-1287
- NPI assigned
- Jul 24, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 036153082 | IL | |
| Interventional Cardiology Physician | 207RI0011X | 036153082 | IL | Primary |
Addresses
Primary practice location
409 W Oak St
Carbondale, IL 62901-1464
Mailing address
PO Box 3988
Carbondale, IL 62902-3988
Phone (618) 457-5200
Other practice location 1
900 N Washington St Ste 2
Du Quoin, IL 62832-1233
Phone (618) 529-4455
Other practice location 2
217 S Park Ave Ste 2
Herrin, IL 62948-3611
Phone (618) 529-4455
Other practice location 3
3905 W Ernestine Dr
Marion, IL 62959-5800
Phone (618) 529-4455
Electronic endpoints 4
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kcherukrui40205@sih.direct-ci.com | ||
| Direct Messaging Address | kcherukrui40205@sih.direct-ci.com | ||
| Direct Messaging Address | kcherukrui40205@sih.direct-ci.com | ||
| Direct Messaging Address | kcherukrui40205@sih.direct-ci.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200921002874 | IL | Practitioner - Interventional Cardiology | 3173811718 | Reassigns benefits to 1 organization |
| I20241211000739 | MA | Practitioner - Internal Medicine | 3173811718 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036153082 | IL | MD | Interventional Cardiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern Illinois Medical Services, NFP | Internal Medicine | Current | Accepting new patients |
| Saint Vincent Physician Services, Inc. | Internal Medicine | Current | Accepting new patients |
Locations
201 Bailey Ln
Benton, IL 62812
Phone (618) 438-3113
2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300
409 W Oak St
Carbondale, IL 62901
Phone (618) 536-2565
900 N Washington St
Ste 2
Du Quoin, IL 62832
217 S Park Ave
Ste 2
Herrin, IL 62948
3905 W Ernestine Dr
Marion, IL 62959
Phone (573) 331-5761
123 Summer St
Worcester, MA 01608
Phone (508) 363-6000
123 Summer St
Ste 284
Worcester, MA 01608
123 Summer St
#273
Worcester, MA 01608
Phone (508) 363-6327
Interoperability endpoints
- krishna.cherukuri.1@626.direct.athenahealth.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 and National Provider Directory roles.
-
- Family Medicine Physician
- Worcester, MA
- NPI 1013997329
Internal Medicine, MA
-
- Internal Medicine Physician
- Carbondale, IL
- NPI 1770656837
IL, Internal Medicine
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Southbridge, MA
- NPI 1790780047
Hospital
-
- General Acute Care Hospital
- Leominster, MA
- NPI 1013995133
Hospital
-
- Psychiatric Hospital Unit
- Clinton, MA
- NPI 1285171934
Hospital
-
- General Acute Care Hospital
- Worcester, MA
- NPI 1831151455
Hospital
-
- General Acute Care Hospital
- Worcester, MA
- NPI 1538131214
Hospital
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Saint Vincent Physician Services Inc
Practice addresses (Care Compare)
123 Summer St
Worcester, MA 01608-1216
Phone (508) 363-5000
Hospital & facility affiliations
- St Vincent Hospital
- Umass Memorial Healthalliance Hospitals
- Umass Memorial Medical Center/University Campus
- Athol Memorial Hospital
- Umass Memorial Health - Harrington Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 82 of 100
- Quality
- 55.9
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 72.01
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary angioplasty and stenting | 1-10 |
| Pacemaker insertion or repair | 1-10 |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678320000000",
"number": "1487096962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3988",
"city": "CARBONDALE",
"state": "IL",
"postal_code": "629023988",
"telephone_number": "618-457-5200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "409 W OAK ST",
"city": "CARBONDALE",
"state": "IL",
"postal_code": "629011464",
"telephone_number": "618-529-4455",
"fax_number": "618-351-1287"
}
],
"practiceLocations": [
{
"address_1": "900 N Washington St Ste 2",
"address_purpose": "LOCATION",
"city": "Du Quoin",
"state": "IL",
"postal_code": "628321233",
"country_code": "US",
"telephone_number": "618-529-4455",
"fax_number": "618-351-1287",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "217 S Park Ave Ste 2",
"address_purpose": "LOCATION",
"city": "Herrin",
"state": "IL",
"postal_code": "629483611",
"country_code": "US",
"telephone_number": "618-529-4455",
"fax_number": "618-351-1287",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3905 W Ernestine Dr",
"address_purpose": "LOCATION",
"city": "Marion",
"state": "IL",
"postal_code": "629595800",
"country_code": "US",
"telephone_number": "618-529-4455",
"fax_number": "618-351-1287",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHERUKURI",
"first_name": "KRISHNA CHAITANYA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-07-24",
"last_updated": "2023-03-09",
"certification_date": "2023-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "IL",
"license": "036153082",
"primary": false
},
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "IL",
"license": "036153082",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kcherukrui40205@sih.direct-ci.com",
"affiliation": "N",
"address_1": "409 W Oak St",
"city": "Carbondale",
"state": "IL",
"country_code": "US",
"postal_code": "629011464",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kcherukrui40205@sih.direct-ci.com",
"affiliation": "N",
"address_1": "3905 W Ernestine Dr",
"city": "Marion",
"state": "IL",
"country_code": "US",
"postal_code": "629595800",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kcherukrui40205@sih.direct-ci.com",
"affiliation": "N",
"address_1": "900 N Washington St Ste 2",
"city": "Du Quoin",
"state": "IL",
"country_code": "US",
"postal_code": "628321233",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kcherukrui40205@sih.direct-ci.com",
"affiliation": "N",
"address_1": "217 S Park Ave Ste 2",
"city": "Herrin",
"state": "IL",
"country_code": "US",
"postal_code": "629483611",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Carbondale, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.