Individual provider Active NPI

Ramesh Babu Guthikonda

  • Internal Medicine Physician
  • Marion, IL
National Provider Identifier
1508197997
Registry record updated May 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036126562 Issued in IL
Practice address
3333 W Deyoung St
Marion, IL 62959-5884
Phone
(618) 998-7000
NPI assigned
Jan 25, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036126562 IL Primary

Addresses

Primary practice location

3333 W Deyoung St
Marion, IL 62959-5884

Mailing address

79 Amelia Ave
Livingston, NJ 07039-2942
Phone (973) 519-1260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20150715000707 MO Practitioner - Internal Medicine 1951593821 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poplar Bluff Emergency Physicians, LLCGroup PAC ID 0648424614, 14 clinicians
Missouri HB Medical Services LLCGroup PAC ID 2668813197, 77 clinicians

Practice addresses (Care Compare)

3100 Oak Grove Rd
Poplar Bluff, MO 63901-1573
Phone (573) 776-2000

Hospital & facility affiliations

  • Poplar Bluff Regional Medical Center Hospital, Poplar Bluff, MO, CCN 260119

Merit-based Incentive Payment System (MIPS)

Final score
50.12 of 100Reported as group
Quality
2.83
Improvement activities
40
Cost
82.51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036126562ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Missouri HB Medical Services, LLC CurrentSince May 1, 2024 Accepting new patients
Butler Physician Services, LLC Internal Medicine CurrentSince Jul 22, 2017 Accepting new patients

Locations

3100 Oak Grove Rd
Rombauer, MO 63901
Phone (573) 776-2000

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.

Hospital & facility affiliations 1

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": "1264377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399248000000",
    "number": "1508197997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 AMELIA AVE",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070392942",
            "telephone_number": "973-519-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 W DEYOUNG ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595884",
            "telephone_number": "618-998-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTHIKONDA",
        "first_name": "RAMESH",
        "middle_name": "BABU",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-25",
        "last_updated": "2014-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036126562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IL

Sources for this page

Verify at the official NPI Registry.