Individual provider Active NPI

Yamini Chalikonda

  • Family Medicine Physician
  • Manchester, CT
National Provider Identifier
1801459532
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
72034 Issued in CT
Practice address
515 Middle Tpke W
Manchester, CT 06040-3816
Phone
(860) 533-4176
NPI assigned
Apr 18, 2019
Last updated
Oct 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 72034 CT Primary

Addresses

Primary practice location

515 Middle Tpke W
Manchester, CT 06040-3816

Mailing address

515 Middle Tpke W
Manchester, CT 06040-3816
Phone (860) 533-4176

Other practice location 1

111 N Washington Ave
Scranton, PA 18503-1828
Phone (570) 343-2383

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20221101003338 CT Practitioner - Family Practice 6800263062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prohealth Physicians PCGroup PAC ID 1355246950, 214 clinicians

Practice addresses (Care Compare)

515 Middle W Turnpike
Manchester, CT 06040-3816
Phone (860) 646-3814

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Physicians PC Family Medicine CurrentSince Oct 10, 2022 Accepting new patients

Locations

3 Farm Glen Blvd
Farmington, CT 06032
Phone (860) 284-5200

515 Middle Tpke W
Manchester, CT 06040
Phone (860) 533-4176

115 Spencer St
Winsted, CT 06098
Phone (860) 738-5810

Interoperability endpoints

  • Direct secure messaging: yamini.chalikonda.npi1801459532.phpct@direct.optumcare.masshiway.net

Organizations & group practices 1

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.

Hospital & facility affiliations 5

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": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1801459532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 MIDDLE TPKE W",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060403816",
            "telephone_number": "860-533-4176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 MIDDLE TPKE W",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060403816",
            "telephone_number": "860-533-4176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 N Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Scranton",
            "state": "PA",
            "postal_code": "185031828",
            "country_code": "US",
            "telephone_number": "570-343-2383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHALIKONDA",
        "first_name": "YAMINI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-18",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "72034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.