Shanti K Neerukonda, M.D.

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

K0148 Issued in TX

Practice address

501 Golder Ave Ste 202-a
Odessa, TX 79761-4411

Phone

(432) 333-6200

Fax

(432) 333-6213

NPI assigned

Jul 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Shanti K Neerukonda Professional name

Medicare fee-for-service enrollment

Enrolled in TX

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

Cardiovascular Disease (Cardiology)

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Big Bend Medical GroupGroup PAC ID 2163326281, 46 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Odessa Regional Medical Center Hospital, Odessa, TX, CCN 450661
• Medical Center Hospital Hospital, Odessa, TX, CCN 450132
• Reeves Regional Health Hospital, Pecos, TX, CCN 451377
• Pecos County Memorial Hospital Hospital, Fort Stockton, TX, CCN 451389
• Big Bend Regional Medical Center Hospital, Alpine, TX, CCN 451378

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shanti.neerukonda.1@1603.direct.athenahealth.com

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.

• Big Bend Medical Group

  dba Family Medical Center

  • Surgery Physician
  • Big Spring, TX
  • NPI 1811973282
  Medicare reassignment Care Compare group NPD
• Big Bend Medical Group

  • Rural Health Clinic/Center
  • Big Spring, TX
  • NPI 1790592004
  NPD
• Odessa Regional Hospital LP

  • General Acute Care Hospital
  • Odessa, TX
  • NPI 1801852736
  NPD (past)

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

• Big Bend Hospital Corporation

  dba Big Bend Regional Medical Center

  • Critical Access Hospital
  • Alpine, TX
  • NPI 1356312243
  Care Compare affiliation
• Ector County Hospital District

  dba MCH Family Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Odessa, TX
  • NPI 1578265302

  Hospital

  Care Compare affiliation
• Ector County Hospital District

  dba Medical Center Hospital

  • General Acute Care Hospital
  • Odessa, TX
  • NPI 1740273994
  Care Compare affiliation
• Odessa Texas Hospital Company LLC

  dba Odessa Regional Medical Center

  • General Acute Care Hospital
  • Odessa, TX
  • NPI 1306673009
  Care Compare affiliation
• Pecos County Memorial Hospital District

  • Critical Access Hospital
  • Fort Stockton, TX
  • NPI 1073200309
  Care Compare affiliation
• Reeves County Hospital District

  dba Reeves Regional Health

  • Critical Access Hospital
  • Pecos, TX
  • NPI 1831170273
  Care Compare affiliation

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1740219807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 GOLDER AVE STE 202-A",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614411",
            "telephone_number": "432-333-6200",
            "fax_number": "432-333-6213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 GOLDER AVE STE 202-A",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614411",
            "telephone_number": "432-333-6200",
            "fax_number": "432-333-6213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEERUKONDA",
        "first_name": "SHANTI",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "K0148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANTI",
            "last_name": "NEERUKONDA",
            "middle_name": "K",
            "credential": "M.D., P.A.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Veronica Navarrette, LCDC
• Larissa R Navarro, AUD
• Navytrained Anesthesia Services
• Shashank Satish Nayak, M.D.
• Stella Neboh
• Rickey Floyd Neff, BS, R.PH.
• Lutfor Nessa, MD, MPH
• Neuro-Sensory Center, L.P.
• Aaron Nevarez
• Kathleen Newton, CRNA

• Interventional Cardiology Physician in Odessa, TX
• Providers in Odessa, TX by specialty
• Interventional Cardiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.