Individual provider Active NPI

Krishna Nimmagadda

  • Hospitalist Physician
  • Yuma, AZ
National Provider Identifier
1801176805
Registry record updated Nov 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
48933 Issued in AZ
Practice address
2400 S Avenue a
Yuma, AZ 85364-7170
Phone
(928) 344-2000
NPI assigned
Aug 22, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 249027 MA
Internal Medicine Physician 207R00000X MD61306614 WA
Hospitalist Physician 208M00000X 48933 AZ Primary

Addresses

Primary practice location

2400 S Avenue a
Yuma, AZ 85364-7170

Mailing address

123 Summer St
Worcester, MA 01608-1216

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221118001139 WA Practitioner - Internal Medicine 8022238260 Reassigns benefits to 1 organization
I20260529002661 OH Practitioner - Internal Medicine 8022238260 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2005
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3170 Kettering Blvd
Moraine, OH 45439-1924

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
249027MAMDInternal Medicine Physician
MD61306614WAMDInternal Medicine Physician
48933AZMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Sound Inpatient Physicians PLLC Family Medicine CurrentSince Sep 7, 2022 Accepting new patients
South Sound Inpatient Physicians PLLC Family Medicine Current Accepting new patients
South Sound Inpatient Physicians PLLC Family Medicine CurrentSince Sep 7, 2022 Accepting new patients
Cogent Healthcare of Washington, PC Family Medicine CurrentSince Sep 7, 2022 Accepting new patients

Locations

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

202 N Division St
Auburn, WA 98001
Phone (253) 333-2562

16251 Sylvester Rd SW
Burien, WA 98166
Phone (206) 244-9970

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

2000 Hospital Dr
Sedro Woolley, WA 98284
Phone (360) 856-6021

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1313971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1801176805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 SUMMER ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 S AVENUE A",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853647170",
            "telephone_number": "928-344-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIMMAGADDA",
        "first_name": "KRISHNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-22",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "249027",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD61306614",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AZ",
            "license": "48933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

Verify at the official NPI Registry.