Active NPI
Kiran Venkat Chunduri, M.D.
- Diagnostic Radiology Physician
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 2014009240
- Practice address
- 10010 Kennerly Rd
Saint Louis, MO 63128-2106 - Phone
- (314) 525-4492
- Fax
- (314) 525-4481
- NPI assigned
- Apr 8, 2009
- Last updated
- Oct 29, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 0435348 | KS | |
| Diagnostic Radiology Physician | 2085R0202X | 52682 | TN | |
| Diagnostic Radiology Physician | 2085R0202X | 0101258263 | VA | |
| Diagnostic Radiology Physician | 2085R0202X | 26330 | WV | |
| Diagnostic Radiology Physician | 2085R0202X | 2014009240 | MO | Primary |
| Vascular & Interventional Radiology Physician | 2085R0204X | 2014009240 | MO |
Addresses
Primary practice location
10010 Kennerly Rd
Saint Louis, MO 63128-2106
Mailing address
11475 Olde Cabin Rd Ste 200
Saint Louis, MO 63141-7129
Phone (314) 991-8200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639312598 | Medicaid | MO |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- University of Missouri, Kansas City, School of Medicine, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 525-1165
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.77 of 100
- Quality
- 86.95
- Improvement activities
- 40
- Cost
- 73.15
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 52682 | TN | MD | Diagnostic Radiology Physician |
| 0101258263 | VA | MD | Diagnostic Radiology Physician |
| 26330 | WV | MD | Diagnostic Radiology Physician |
Organizations & group practices 1
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.
-
- Diagnostic Radiology Physician
- Saint Louis, MO
- NPI 1477500585
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Festus, MO
- NPI 1508859661
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1568481984
-
dba Mercy Hospital Washington
- General Acute Care Hospital
- Washington, MO
- NPI 1285664177
-
dba Mercy Hospital St Louis
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1427098169
-
dba Mercy St. Louis Transport Ambulance
- Land Ambulance
- Saint Louis, MO
- NPI 1881329902
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603929600000",
"number": "1639312598",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11475 OLDE CABIN RD STE 200",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631417129",
"telephone_number": "314-991-8200",
"fax_number": "314-991-8206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10010 KENNERLY RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631282106",
"telephone_number": "314-525-4492",
"fax_number": "314-525-4481"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUNDURI",
"first_name": "KIRAN",
"middle_name": "VENKAT",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-04-08",
"last_updated": "2020-10-29",
"certification_date": "2020-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "KS",
"license": "0435348",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "TN",
"license": "52682",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "VA",
"license": "0101258263",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "WV",
"license": "26330",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MO",
"license": "2014009240",
"primary": true
},
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "MO",
"license": "2014009240",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1639312598",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; 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.