Individual provider Active NPI

Padmavathi V Rudraraju

  • Family Nurse Practitioner
  • Marion, OH
National Provider Identifier
1588136790
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
023693 Issued in OH
Practice address
1000 McKinley Park Dr
Marion, OH 43302-6399
Phone
(740) 383-8473
NPI assigned
Dec 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 023693 OH Primary

Addresses

Primary practice location

1000 McKinley Park Dr
Marion, OH 43302-6399

Mailing address

1000 McKinley Park Dr
Marion, OH 43302-6399
Phone (740) 383-8473

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address prudraraju338552@direct.ohiohealth.com OhioHealth Physician Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210203002837 OH Practitioner - Nurse Practitioner 1658785571 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians

Practice addresses (Care Compare)

1000 McKinley Park Dr
Marion, OH 43302-6399
Phone (740) 383-8400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.04 of 100Reported as group
Quality
58.67
Promoting interoperability
98
Improvement activities
40
Cost
76.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
023693OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Jan 1, 2021 Accepting new patients
Ohiohealth Corporation CurrentSince Jan 1, 2021 Accepting new patients
Ohiohealth Corporation Current Accepting new patients

Locations

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

Dept L3652
Columbus, OH 43260

5450 Frantz Rd
Ste 360
Dublin, OH 43016
Phone (614) 533-6497

1000 McKinley Park Dr
Marion, OH 43302
Phone (740) 383-8400

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1545955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1588136790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MCKINLEY PARK DR",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433026399",
            "telephone_number": "740-383-8473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MCKINLEY PARK DR",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433026399",
            "telephone_number": "740-383-8473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDRARAJU",
        "first_name": "PADMAVATHI",
        "middle_name": "V",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-28",
        "last_updated": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "023693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "prudraraju338552@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group",
            "address_1": "1000 McKinley Park Dr",
            "city": "Marion",
            "state": "OH",
            "country_code": "US",
            "postal_code": "433026399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marion, OH

Sources for this page

Verify at the official NPI Registry.