Dheeraj Kodali, M.D.

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

A172284 Issued in CA

Practice address

2626 N California St Ste B
Stockton, CA 95204-5500

Phone

(209) 466-2626

Fax

(209) 466-7153

NPI assigned

Jul 17, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Hematology/Oncology

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Stockton Hematology Oncology Medical Group IncGroup PAC ID 1456369800, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mark Twain Medical Center Hospital, San Andreas, CA, CCN 051332
• Sutter Tracy Community Hospital Hospital, Tracy, CA, CCN 050313
• Doctors Medical Center Hospital, Modesto, CA, CCN 050464
• St Joseph'S Medical Center of Stockton Hospital, Stockton, CA, CCN 050084
• Doctors Hospital of Manteca Hospital, Manteca, CA, CCN 050118

Merit-based Incentive Payment System (MIPS)

Final score

93.02 of 100Reported as group

Quality

71.01

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: dheerajkodali@arh.medalliesdirect.net
• Direct secure messaging: dheeraj.kodali@wvafn.hcadirect.net
• FHIR API: https://fhir.prod.flatiron.io/fhir/
• Direct secure messaging: dkodali589474@hisp.ehr.sutterhealth.org

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.

• Stockton Hematology Oncology Medical Group, Inc

  • Specialist
  • Stockton, CA
  • NPI 1922175074

  Hematology & Oncology

  Medicare reassignment Care Compare group NPD
• Mark Twain Medical Center

  • Critical Access Hospital
  • San Andreas, CA
  • NPI 1508968819
  Medicare reassignment NPD
• Appalachian Regional Healthcare, Inc

  • Family Medicine Physician
  • Beckley, WV
  • NPI 1477510162

  Hematology & Oncology

  NPD
• Appalachian Regional Healthcare, Inc

  • Community/Retail Pharmacy
  • Cumberland, KY
  • NPI 1710870811
  NPD
• Dameron Hospital Association

  • General Acute Care Hospital
  • Stockton, CA
  • NPI 1538163886
  NPD (past)
• Dignity Health

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1487694857
  NPD (past)
• Hill Physicians Medical Group - PPO Program

  • Preferred Provider Organization
  • San Ramon, CA
  • NPI 1679011035
  NPD (past)
• Port City Operating Company, LLC

  • General Acute Care Hospital
  • Stockton, CA
  • NPI 1528190931
  NPD (past)
• Appalachian Regional Healthcare, Inc.

  • Clinical Pathology/Laboratory Medicine Physician
  • Beckley, WV
  • NPI 1417048539
  NPD (past)
• St Joseph Regional Health Network

  • General Acute Care Hospital
  • Reading, PA
  • NPI 1699734665
  NPD (past)

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

• Doctors Hospital of Manteca, Inc.

  • General Acute Care Hospital
  • Manteca, CA
  • NPI 1992736599
  Care Compare affiliation
• Doctors Medical Center of Modesto, Inc.

  • General Acute Care Hospital
  • Modesto, CA
  • NPI 1184654923
  Care Compare affiliation
• Mark Twain Medical Center

  • Critical Access Hospital
  • San Andreas, CA
  • NPI 1508968819
  Care Compare affiliation
• Port City Operating Company, LLC

  • General Acute Care Hospital
  • Stockton, CA
  • NPI 1528190931
  Care Compare affiliation
• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Tracy, CA
  • NPI 1821442864
  Care Compare affiliation

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

{
    "created_epoch": "1279324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1508179607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2626 N CALIFORNIA ST STE B",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045500",
            "telephone_number": "209-466-2626",
            "fax_number": "209-466-7153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 N CALIFORNIA ST STE B",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045500",
            "telephone_number": "209-466-2626",
            "fax_number": "209-466-7153"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 Stanaford Rd",
            "address_purpose": "LOCATION",
            "city": "Beckley",
            "state": "WV",
            "postal_code": "258013140",
            "country_code": "US",
            "telephone_number": "304-254-3520",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3110 MacCorkle Ave SE",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253041210",
            "country_code": "US",
            "telephone_number": "304-388-1000",
            "fax_number": "304-388-1041",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 Summers Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Hinton",
            "state": "WV",
            "postal_code": "259515172",
            "country_code": "US",
            "telephone_number": "340-255-2918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KODALI",
        "first_name": "DHEERAJ",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-17",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "WV",
            "license": "26214",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WV",
            "license": "26214",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "A172284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael S Ko, DPT.,ATC
• Michael Shou Kobayashi, MD
• Prince Njangula Kobba, LPT
• Rosebud C Kocher
• Pamela Kochi-Lam, RN, PHN
• Lauren Koehler
• Susan Koehnen, RPH
• Thomas Koesterer, PH.D., ATC
• Carolynn Kohn, PHD, BCBA-D
• Michelle Acojido Koide, PHARM. D

• Hematology & Oncology Physician in Stockton, CA
• Providers in Stockton, CA by specialty
• Hematology & Oncology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; 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.