Individual provider Active NPI

Sue Pallekonda, MD, MBBS

  • Family Medicine Physician
  • Fishers, IN
National Provider Identifier
1689697757
Registry record updated Aug 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01058024A Issued in IN
Practice address
9820 E 141St St Ste 100
Fishers, IN 46038-9303
Phone
(317) 794-2432
Fax
(317) 799-9669
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01058024A IN Primary

Addresses

Primary practice location

9820 E 141St St Ste 100
Fishers, IN 46038-9303

Mailing address

6340 Woburn Dr
Indianapolis, IN 46250-2742
Phone (317) 599-7681

Other identifiers 2

IdentifierTypeStateIssuer
P00249958OtherINRR MEDICARE
000000329169OtherINANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01058024AINMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: sue.pallekonda@552078586675204.direct.elationemr.com
  • Direct secure messaging: spallekonda10855@ecommunitydirect.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693094400000",
    "number": "1689697757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6340 WOBURN DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502742",
            "telephone_number": "317-599-7681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9820 E 141ST ST STE 100",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460389303",
            "telephone_number": "317-794-2432",
            "fax_number": "317-799-9669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALLEKONDA",
        "first_name": "SUE",
        "credential": "MD, MBBS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2023-08-27",
        "certification_date": "2023-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01058024A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00249958",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000329169",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishers, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.