Individual provider Active NPI

Pradeep Vamanrao Kalokhe, M.D.

  • Neurology Physician
  • Highland, IN
National Provider Identifier
1760554067
Registry record updated Nov 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
01031327A Issued in IN
Practice address
8427 Kennedy Ave
Highland, IN 46322-1140
Phone
(219) 838-1718
Fax
(219) 838-4883
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 01031327A IN Primary

Addresses

Primary practice location

8427 Kennedy Ave
Highland, IN 46322-1140

Mailing address

PO Box 9208
Highland, IN 46322-9208
Phone (219) 838-1718

Other identifiers 1

IdentifierTypeStateIssuer
100212640AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20080311000635 IN Practitioner - Neurology 3870550114 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01031327AINMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Network Inc Neurology CurrentSince Nov 1, 2017 Accepting new patients

Locations

5454 Hohman Ave
Hammond, IN 46320
Phone (219) 933-2077

8427 Kennedy Ave
Highland, IN 46322
Phone (219) 838-1718

9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510531200000",
    "number": "1760554067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9208",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463229208",
            "telephone_number": "219-838-1718",
            "fax_number": "219-838-4883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8427 KENNEDY AVE",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463221140",
            "telephone_number": "219-838-1718",
            "fax_number": "219-838-4883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALOKHE",
        "first_name": "PRADEEP",
        "middle_name": "VAMANRAO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2017-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IN",
            "license": "01031327A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100212640A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland, IN

Sources for this page

Verify at the official NPI Registry.