NPIMap

Individual provider Active NPI

Usha V Kanakamedala, MD

  • Diagnostic Radiology Physician
  • Port Matilda, PA
National Provider Identifier
1801840236
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD061561L Issued in PA
Practice address
132 Abigail Lane
Port Matilda, PA 16870-5700
Phone
(814) 272-7100
NPI assigned
May 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD061561L PA Primary

Addresses

Primary practice location

132 Abigail Lane
Port Matilda, PA 16870-5700

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041208000406 PA Practitioner - Diagnostic Radiology 8820054182 Reassigns benefits to 2 organizations
I20141016000760 TX Practitioner - Diagnostic Radiology 8820054182 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
State University of New York Downstate Medical Center, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians
Geisinger-HM Joint Venture LLCGroup PAC ID 1355676370, 426 clinicians

Practice addresses (Care Compare)

132 Abigail LN
Port Matilda, PA 16870-7153
Phone (814) 272-7100

529 High St
Lock Haven, PA 17745-3029
Phone (570) 748-8038

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD061561LPAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation CurrentSince Oct 1, 2014 Accepting new patients
Zuni Indian Hospital CurrentSince Jan 30, 2015 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger-HM Joint Venture, LLC CurrentSince Nov 12, 2019 Accepting new patients
Clinton Indian Health Center CurrentSince Jan 1, 2015 Accepting new patients
Geisinger Clinic Diagnostic Radiology CurrentSince Aug 1, 2017 Accepting new patients
Geisinger-HM Joint Venture, LLC Diagnostic Radiology Current Accepting new patients
Cherokee Nation CurrentSince Oct 1, 2014 Accepting new patients
Geisinger Clinic Diagnostic Radiology CurrentSince Aug 1, 2017 Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Professional X-Ray Associates Diagnostic Radiology Past Accepting new patients

Locations

501 E 5th St
Bartlesville, OK 74003
Phone (918) 336-0823

10321 N 2274 Rd
Clinton, OK 73601
Phone (580) 331-3300

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1515 NE Lawrie Tatum Rd
Lawton, OK 73507
Phone (580) 353-0350

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

100 N Academy Ave
Danville, PA 17822

529 High St
Lock Haven, PA 17745
Phone (570) 743-1703

10 Choate Cir
Montoursville, PA 17754
Phone (570) 368-5566

132 Abigail Ln
Port Matilda, PA 16870
Phone (814) 272-5011

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 57

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

View all 57

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1801840236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 ABIGAIL LANE",
            "city": "PORT MATILDA",
            "state": "PA",
            "postal_code": "168705700",
            "telephone_number": "814-272-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANAKAMEDALA",
        "first_name": "USHA",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD061561L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Matilda, PA

Sources for this page

Verify at the official NPI Registry.