Individual provider Active NPI

Vishnu V Mudrakola, D.O

  • Emergency Medicine Physician
  • Columbus, OH
National Provider Identifier
1740673318
Registry record updated Nov 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
58.007054 Issued in OH
Practice address
5100 W Broad St
Columbus, OH 43228-1607
Phone
(614) 544-1000
NPI assigned
Mar 6, 2015
Last updated
Nov 16, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 58.007054 OH Primary

Addresses

Primary practice location

5100 W Broad St
Columbus, OH 43228-1607

Mailing address

240 Valencia Pkwy
Gilberts, IL 60136-8012
Phone (630) 696-5715

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
I20180827003611 OH Practitioner - Emergency Medicine 8325314628 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
94.51
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58.007054OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Physicians of Cuyahoga County, LTD Emergency Medicine CurrentSince Jul 1, 2022 Accepting new patients
Emergency Medicine Physicians of Franklin County, LTD Emergency Medicine CurrentSince Dec 5, 2019 Accepting new patients

Locations

141 N Forge St
Akron, OH 44304
Phone (330) 375-3361

155 5th St NE
Barberton, OH 44203
Phone (330) 615-3000

5100 W Broad St
New Rome, OH 43228
Phone (614) 544-1000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1425600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447632000000",
    "number": "1740673318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 VALENCIA PKWY",
            "city": "GILBERTS",
            "state": "IL",
            "postal_code": "601368012",
            "telephone_number": "630-696-5715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432281607",
            "telephone_number": "614-544-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDRAKOLA",
        "first_name": "VISHNU",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-06",
        "last_updated": "2015-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "58.007054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.