Venkateswara R Kanubaddi, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

01028849A Issued in IN

Practice address

2121 Lake Ave
Fort Wayne, IN 46805-5100

Phone

(260) 426-5431

Fax

(260) 460-1383

NPI assigned

Jul 1, 2005

Last updated

Jun 18, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Parkview Health System Inc

  dba Parkview Physicians Group

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1932130952

  Anesthesiology

  NPD (past)
• Preferred Anesthesia Consultants, P.C.

  • Anesthesiology Physician
  • Fort Wayne, IN
  • NPI 1639176837
  NPD (past)

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371513600000",
    "number": "1750388955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1928 SYCAMORE HILLS DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468149304",
            "telephone_number": "260-625-3540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055100",
            "telephone_number": "260-426-5431",
            "fax_number": "260-460-1383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANUBADDI",
        "first_name": "VENKATESWARA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2013-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01028849A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BC",
            "identifier": "000000082079",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100323110A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacey Kammer
• Benjamin Sheldon Kammerer
• William Allen Kammeyer, M.D.
• Jessica Kampfe
• Pardha Kanagala, M.D.
• Reshi C Kanuru, M.D.
• Martin J Kaplan, M.D
• Paul Traianos Kaplanis, M.D.
• Bryan Dale Kaplansky, M.D.
• Ashok Kapur, M.D.

• Anesthesiology Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Anesthesiology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2013; 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.