NPIMap

Individual provider Active NPI

Kishore Nallu, M.D.

  • Cardiovascular Disease Physician
  • Lima, OH
National Provider Identifier
1568709657
Registry record updated Jul 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
35131382 Issued in OH
Practice address
730 W Market St Ste 2K
Lima, OH 45801-4602
Phone
(419) 996-5852
Fax
(419) 996-5854
NPI assigned
Jan 9, 2013
Last updated
Jul 14, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 53627 CT
Cardiovascular Disease Physician 207RC0000X 35131382 OH Primary

Addresses

Primary practice location

730 W Market St Ste 2K
Lima, OH 45801-4602

Mailing address

PO Box 636930
Cincinnati, OH 45263-6930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170801003276 OH Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 8123336856 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Interventional Cardiology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Lima Specialty Care LLCGroup PAC ID 7012332364, 254 clinicians

Practice addresses (Care Compare)

730 W Market St
Suite 2K
Lima, OH 45801-4602
Phone (419) 996-5852

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting82
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53627CTMDInternal Medicine Physician
35131382OHMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Lima Specialty Care LLC Cardiovascular Disease CurrentSince Sep 1, 2020 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

730 W Market St
Lima, OH 45801
Phone (419) 226-4310

730 W Market St
Ste 2K
Lima, OH 45801
Phone (419) 996-4011

770 W High St
Lima, OH 45801
Phone (419) 996-5240

770 W High St
Ste 450
Lima, OH 45801
Phone (419) 996-5069

830 W High St
Ste 390
Lima, OH 45801
Phone (419) 995-4960

967 Bellefontaine Ave
Lima, OH 45804
Phone (419) 224-1330

601 US Route 224
Ottawa, OH 45875
Phone (419) 228-8950

Interoperability endpoints

  • Direct secure messaging: knallu322059@direct.bsmhealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1357689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499990400000",
    "number": "1568709657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636930",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 W MARKET ST STE 2K",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458014602",
            "telephone_number": "419-996-5852",
            "fax_number": "419-996-5854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NALLU",
        "first_name": "KISHORE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-09",
        "last_updated": "2017-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "53627",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35131382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

Verify at the official NPI Registry.