Individual provider Active NPI

Vagesh Mahadevappa Hampole, MD

  • Rheumatology Physician
  • Elyria, OH
National Provider Identifier
1699777102
Registry record updated Mar 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
35042723 Issued in OH
Practice address
125 E Broad St
Ste 215
Elyria, OH 44035-6400
Phone
(440) 329-7360
Fax
(440) 329-7410
NPI assigned
Aug 15, 2005
Last updated
Mar 24, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35042723 OH
Rheumatology Physician 207RR0500X 35042723 OH Primary

Addresses

Primary practice location

125 E Broad St
Ste 215
Elyria, OH 44035-6400

Mailing address

125 E Broad St
Ste 215
Elyria, OH 44035-6400
Phone (440) 329-7360

Other identifiers 2

IdentifierTypeStateIssuer
0490633MedicaidOH
3041765MedicaidOH

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
I20100602000121 OH Practitioner - Rheumatology 8729117635 Practice locations: Elyria, OH

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

125 E Broad St
Suite 215
Elyria, OH 44035-6429

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35042723OHMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Om Healthcare LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: vhampole37215@ehrdirect.uhhospitals.org

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.

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": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395619200000",
    "number": "1699777102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 E BROAD ST",
            "address_2": "STE 215",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440356400",
            "telephone_number": "440-329-7360",
            "fax_number": "440-329-7410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E BROAD ST",
            "address_2": "STE 215",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440356400",
            "telephone_number": "440-329-7360",
            "fax_number": "440-329-7410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMPOLE",
        "first_name": "VAGESH",
        "middle_name": "MAHADEVAPPA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2014-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35042723",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "OH",
            "license": "35042723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0490633",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3041765",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elyria, OH

Sources for this page

Verify at the official NPI Registry.