Individual provider Active NPI

Kalyana Koneru, M.D.

  • Internal Medicine Physician
  • Abington, PA
National Provider Identifier
1841450343
Registry record updated Apr 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD437553 Issued in PA
Practice address
1200 Old York Rd
Abington, PA 19001-3720
Phone
(215) 481-2000
NPI assigned
Jun 10, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT188468 PA
Internal Medicine Physician 207R00000X MD437553 PA Primary

Addresses

Primary practice location

1200 Old York Rd
Abington, PA 19001-3720

Mailing address

458 Meadowbrook Dr
Huntingdon Valley, PA 19006-6831
Phone (267) 401-9468

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20100802000144 AR Practitioner - Internal Medicine 3577619691 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Health GroupGroup PAC ID 7911802079, 645 clinicians

Practice addresses (Care Compare)

3333 Springhill Dr
North Little Rock, AR 72117-2922
Phone (501) 851-7402

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT188468PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ozark Health, Inc CurrentSince Oct 28, 2017 Accepting new patients
Arkansas Health Group Internal Medicine CurrentSince Jul 5, 2010 Accepting new patients
Arkansas Health Group CurrentSince Jul 5, 2010 Accepting new patients
Ozark Health, Inc CurrentSince Oct 28, 2017 Accepting new patients
Baptist Health CurrentSince Jan 13, 2020 Accepting new patients
Baptist Health CurrentSince Jan 13, 2020 Accepting new patients

Locations

2500 Highway 65 S
Clinton, AR 72031
Phone (501) 745-7000

9601 Interstate 630
#7
Little Rock, AR 72205
Phone (501) 202-3995

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

9601 Baptist Health Dr
Little Rock, AR 72205
Phone (501) 202-3995

3333 Springhill Dr
North Little Rock, AR 72117
Phone (501) 202-3000

Interoperability endpoints

  • Direct secure messaging: kkoneru5255@direct.baptist-healthar.org
  • FHIR API: https://fhir-usa.unify.chbase.com/org/ozarkh-5b939301

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.

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": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271030400000",
    "number": "1841450343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "458 MEADOWBROOK DR",
            "city": "HUNTINGDON VALLEY",
            "state": "PA",
            "postal_code": "190066831",
            "telephone_number": "267-401-9468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 OLD YORK RD",
            "city": "ABINGTON",
            "state": "PA",
            "postal_code": "190013720",
            "telephone_number": "215-481-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONERU",
        "first_name": "KALYANA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-10",
        "last_updated": "2010-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT188468",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD437553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abington, PA

Sources for this page

Verify at the official NPI Registry.