Kelly Pannikodu, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

18101 Lorain Ave
Cleveland, OH 44111-5612

Phone

(216) 476-7000

NPI assigned

Mar 31, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

Hospitalist

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southcoast Physicians Group IncGroup PAC ID 0749171957, 875 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hospice and Palliative Care Hospice, Fairhaven, MA, CCN 221536
• Southcoast Hospitals Group Hospital, Fall River, MA, CCN 220074

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kpannikodu87286@direct.southcoast.org

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.

• Southcoast Physicians Group, Inc.

  • Family Medicine Physician
  • Fairhaven, MA
  • NPI 1336137629
  Medicare reassignment Care Compare group NPD
• Southcoast Physicians Group, Inc.

  • Orthopaedic Surgery Physician
  • North Dartmouth, MA
  • NPI 1902201536
  NPD
• Southcoast Hospitals Group, Inc

  dba St. Luke's Hospital

  • General Acute Care Hospital
  • New Bedford, MA
  • NPI 1447275037
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Southcoast Hospitals Group, Inc

  dba Tobey Hospital

  • General Acute Care Hospital
  • Wareham, MA
  • NPI 1922024835
  Care Compare affiliation
• Southcoast Visiting Nurse Association, Inc

  • Community Based Hospice Care Agency
  • Fairhaven, MA
  • NPI 1801990452
  Care Compare affiliation

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

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1710627385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18101 LORAIN AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441115612",
            "telephone_number": "216-476-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18101 LORAIN AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441115612",
            "telephone_number": "216-476-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANNIKODU",
        "first_name": "KELLY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-31",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Pankey
• Caitlyn Marie Pankuch
• Veronica Ann Pankuch
• Unique Artilla Pannell
• Abigail Panneton, MD
• David Panning
• Andrea Pannunzio
• Lubjanka Pano
• Panorama Healthcare LLC
• Gemma Lee Pansch, DO

• Student in an Organized Health Care Education/Training Program in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Student in an Organized Health Care Education/Training Program in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; 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.

Verify at the official NPI Registry.