NPIMap

Individual provider Active NPI

Indukala Doddamane, MBBS

  • Nuclear Medicine Physician
  • Bronx, NY
National Provider Identifier
1780667113
Registry record updated Oct 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Medicine PhysicianTaxonomy code 207U00000X
License
230974-01 Issued in NY
Practice address
1400 Pelham Pkwy S
Bronx, NY 10461-1138
Phone
(718) 918-3044
NPI assigned
Nov 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine Physician 207U00000X 043712 CT
Nuclear Medicine Physician 207U00000X 230974-01 NY Primary

Addresses

Primary practice location

1400 Pelham Pkwy S
Bronx, NY 10461-1138

Mailing address

415 Gunnar CT
Cheshire, CT 06410-1991
Phone (203) 439-2041

Other practice location 1

20 York St
YNHH Smilow Cancer Center, IInd floor
New Haven, CT 06510-3220
Phone (203) 200-5160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051020000443 CT Practitioner - Nuclear Medicine 5193741023 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nuclear Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Nuclear Medicine GroupGroup PAC ID 9638068067, 37 clinicians
Connecticut Imaging Partners LLCGroup PAC ID 4183649098, 105 clinicians
Tic LLCGroup PAC ID 4880972819, 52 clinicians
Jefferson Radiology PCGroup PAC ID 8729982525, 121 clinicians

Practice addresses (Care Compare)

Cheshire, CT 06410
Phone (212) 639-2000

100 Hazard Ave
Suite 100
Enfield, CT 06082-5447
Phone (860) 289-3375

6 Fieldstone CMNS
Suite E
Tolland, CT 06084-3419
Phone (860) 896-4848

85 Seymour St
Suite 200
Hartford, CT 06106-5509
Phone (860) 289-3375

Hospital & facility affiliations

  • Hartford Hospital Hospital, Hartford, CT, CCN 070025
  • Manchester Memorial Hospital Hospital, Manchester, CT, CCN 070027
  • Griffin Hospital Hospital, Derby, CT, CCN 070031
  • Memorial Hospital for Cancer and Allied Diseases Hospital, New York, NY, CCN 330154
  • Day Kimball Hospital Hospital, Putnam, CT, CCN 070003

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
043712CTMDNuclear Medicine Physician
230974-01NYMDNuclear Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tic, LLC CurrentSince Feb 1, 2023 Accepting new patients
Memorial Nuclear Medicine Group Nuclear Medicine CurrentSince Sep 1, 2024 Accepting new patients

Locations

100 Hazard Ave
Ste 100
Enfield, CT 06082
Phone (860) 696-2380

399 Farmington Ave
Lowr 1
Farmington, CT 06032

85 Seymour St
Ste 200
Hartford, CT 06106
Phone (860) 246-6589

6 Fieldstone Cmns
Ste E
Tolland, CT 06084
Phone (860) 896-4847

633 3rd Ave
Fl 4
New York, NY 10017
Phone (646) 227-3764

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Organizations & group practices 5

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.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570579200000",
    "number": "1780667113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 GUNNAR CT",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064101991",
            "telephone_number": "203-439-2041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 PELHAM PKWY S",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611138",
            "telephone_number": "718-918-3044"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 York St",
            "address_2": "YNHH Smilow Cancer Center, IInd floor",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065103220",
            "country_code": "US",
            "telephone_number": "203-200-5160",
            "fax_number": "203-200-5054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DODDAMANE",
        "first_name": "INDUKALA",
        "name_prefix": "Dr.",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-21",
        "last_updated": "2019-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "CT",
            "license": "043712",
            "primary": false
        },
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "NY",
            "license": "230974-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.