Shanu Kondamuri, M.D.

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

01045126A Issued in IN

Practice address

8840 Calumet Ave
Suite 103
Munster, IN 46321-2545

Phone

(219) 836-7246

Fax

(219) 836-6454

NPI assigned

Jul 14, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Shaun Kondamuri Other name

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

Specialty

Pain Management

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rci (WRS) LLCGroup PAC ID 5092624510, shared by 17 NPIs, 325 clinicians

Pain Management Specialists, LLCGroup PAC ID 9032134770, 3 clinicians

Chesterton Physical Therapy IncGroup PAC ID 3173683984, 191 clinicians

Midwest Pain Management Centers,LLCGroup PAC ID 5496654618, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Hospital Hospital, Munster, IN, CCN 150125
• St Mary Medical Center Inc Hospital, Hobart, IN, CCN 150034

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Pain Management Specialists LLC

  • Pain Clinic/Center
  • Munster, IN
  • NPI 1881693562
  Medicare reassignment Care Compare group NPD Authorized official
• Midwest Pain Management Centers,LLC

  • Pain Medicine Physician
  • Munster, IN
  • NPI 1962401745

  Interventional Pain Medicine

  Medicare reassignment Care Compare group NPD
• Community Care Network Inc

  • Family Medicine Physician
  • St John, IN
  • NPI 1457610487

  Interventional Pain Medicine

  Medicare reassignment NPD
• Chesterton Physical Therapy, Inc.

  • Physical Therapist
  • Chesterton, IN
  • NPI 1467608687
  Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Munster Medical Research Foundation Inc

  • General Acute Care Hospital
  • Munster, IN
  • NPI 1003918210
  Care Compare affiliation
• St Mary Medical Center Inc

  • General Acute Care Hospital
  • Hobart, IN
  • NPI 1558463745
  Care Compare affiliation
• St Mary Medical Center Inc

  • General Acute Care Hospital
  • Hobart, IN
  • NPI 1962504175
  Care Compare affiliation

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323907200000",
    "number": "1497754287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8840 CALUMET AVE",
            "address_2": "SUITE 103",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212545",
            "telephone_number": "219-836-7246",
            "fax_number": "219-836-6454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8840 CALUMET AVE",
            "address_2": "SUITE 103",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212545",
            "telephone_number": "219-836-7246",
            "fax_number": "219-836-6454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONDAMURI",
        "first_name": "SHANU",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2011-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IN",
            "license": "01045126A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ILLINOIS",
            "identifier": "01045126A",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "01045126A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200111560A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "050043847",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000000330844",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAUN",
            "last_name": "KONDAMURI",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• John L Kniaz, DO
• Shannen Idalene Knight
• Maressa Judith Kolo, RPH
• Padmaja Kondamuri, M.D.
• Saveen Kondamuri, M.D.
• Patricia Konvalinka, RN, ANP
• Jay L. Korach, M.D.
• Lisa Koscielski
• Stephan George Kossis, O.D.
• Michele Christine Kotis, NP

• Interventional Pain Medicine Physician in Munster, IN
• Providers in Munster, IN by specialty
• Interventional Pain Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2011; 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.

Verify at the official NPI Registry.