Active NPI
Bhavani Koneru, M.D.
- Internal Medicine Physician
- Toledo, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 35071506
- Practice address
- 2150 W Central Ave
Toledo, OH 43606-3846 - Phone
- (419) 291-2200
- Fax
- (419) 479-3298
- NPI assigned
- Jun 24, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 35071506 | OH | Primary |
Addresses
Primary practice location
2150 W Central Ave
Toledo, OH 43606-3846
Mailing address
2150 W Central Ave
Toledo, OH 43606-3846
Phone (419) 291-2200
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2196903 | Medicaid | OH | |
| 341881137 | Other | OH | FRONT PATH |
| 07603 | Other | OH | PARAMOUNT |
| 1689670531 | Medicaid | MI | |
| 12802 | Other | MI | HEALTH PLAN OF MICHIGAN |
| 141978 | Other | OH | PRIORITY |
| 1689670531 | Other | OH | CIGNA |
| 7779163 | Other | OH | AETNA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | bkoneru26466@epicdirect.promedica.org |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Indiana University School of Medicine, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2150 W Central Ave
Toledo, OH 43606-3834
Phone (419) 291-8701
Hospital & facility affiliations
- Promedica Toledo Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Promedica Central Physicians | Internal Medicine | Current | Accepting new patients |
| Promedica Central Physicians | Current | Accepting new patients |
Locations
100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964
2150 W Central Ave
Toledo, OH 43606
Phone (419) 291-2200
2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111
2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112
1091 Pray Blvd
Waterville, OH 43566
Phone (419) 785-3282
Interoperability endpoints
- bkoneru26466@direct.promedica.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 and National Provider Directory roles.
-
- Family Medicine Physician
- Toledo, OH
- NPI 1306105150
-
- Durable Medical Equipment & Medical Supplies
- Toledo, OH
- NPI 1669068482
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Toledo, OH
- NPI 1407854771
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698969600000",
"number": "1689670531",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2150 W CENTRAL AVE",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436063846",
"telephone_number": "419-291-2200",
"fax_number": "419-479-3298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2150 W CENTRAL AVE",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436063846",
"telephone_number": "419-291-2200",
"fax_number": "419-479-3298"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KONERU",
"first_name": "BHAVANI",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-24",
"last_updated": "2023-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OH",
"license": "35071506",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2196903",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FRONT PATH",
"identifier": "341881137",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARAMOUNT",
"identifier": "07603",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1689670531",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PLAN OF MICHIGAN",
"identifier": "12802",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIORITY",
"identifier": "141978",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "1689670531",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7779163",
"state": "OH"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "bkoneru26466@epicdirect.promedica.org",
"affiliation": "N",
"address_1": "100 Madison Ave",
"city": "Toledo",
"state": "OH",
"country_code": "US",
"postal_code": "436041516",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.