Individual provider Active NPI

Sujit Reddy Muthukuru, M.D.

  • Hospitalist Physician
  • Kettering, OH
National Provider Identifier
1679925689
Registry record updated May 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
35.143101 Issued in OH
Practice address
3535 Southern Blvd
Kettering, OH 45429-1221
Phone
(937) 395-6665
Fax
(937) 395-6668
NPI assigned
Jul 1, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35.134528 OH
Student in an Organized Health Care Education/Training Program 390200000X
Hospitalist Physician 208M00000X 35.143101 OH Primary

Addresses

Primary practice location

3535 Southern Blvd
Kettering, OH 45429-1221

Mailing address

3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-8165

Other identifiers 1

IdentifierTypeStateIssuer
0347626MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address smuthukuru657833@direct.ketteringhealth.org
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190606001895 OH Practitioner - HospitalistPractitioner - Internal Medicine 1557659497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians

Practice addresses (Care Compare)

3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-8646

4403 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 433-5309

4441 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 298-7751

Hospital & facility affiliations

  • Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079
  • Kettering Health Dayton Hospital, Dayton, OH, CCN 360133

Merit-based Incentive Payment System (MIPS)

Final score
81.34 of 100Reported as group
Quality
63.67
Promoting interoperability
100
Improvement activities
40
Cost
74.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.134528OHMDInternal Medicine Physician
35.143101OHMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kettering Independent Medical Group Inc Internal Medicine CurrentSince Dec 29, 2022 Accepting new patients
Kettering Medical Center Past Accepting new patients

Locations

405 W Grand Ave
Dayton, OH 45405
Phone (937) 226-3200

3535 Southern Blvd
Kettering, OH 45429
Phone (937) 298-1221

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

2115 Leiter Rd
Ste 300
Miamisburg, OH 45342

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

4000 Miamisburg Centerville Rd
Ste 450
Miamisburg, OH 45342
Phone (937) 439-3600

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 2

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": "1467331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1679925689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 SOUTHERN BLVD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291221",
            "telephone_number": "937-395-8165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 SOUTHERN BLVD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291221",
            "telephone_number": "937-395-6665",
            "fax_number": "937-395-6668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTHUKURU",
        "first_name": "SUJIT",
        "middle_name": "REDDY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-01",
        "last_updated": "2023-05-05",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.134528",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "35.143101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0347626",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smuthukuru657833@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "3535 Southern Blvd",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291221",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3535 Southern Blvd",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

Verify at the official NPI Registry.