Individual provider Active NPI

Nishan Dallakoti, M.D.

  • Hospitalist Physician
  • Great Falls, MT
National Provider Identifier
1841484359
Registry record updated Apr 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
12363 Issued in MT
Practice address
1101 26TH St S
Cogent Healthcare of Montana, PC
Great Falls, MT 59405
Phone
(405) 455-4690
Fax
(405) 455-4691
NPI assigned
Aug 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 261721 MA
Hospitalist Physician 208M00000X 12363 MT Primary

Addresses

Primary practice location

1101 26TH St S
Cogent Healthcare of Montana, PC
Great Falls, MT 59405

Mailing address

5410 Maryland Way
Suite 300 Cogent Healthcare
Brentwood, TN 37027
Phone (615) 377-5600

Other practice location 1

101 Page St
New Bedford, MA 02740-3464
Phone (508) 973-5919

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ndallakoti19838@direct.southcoast.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20150901002202 MA Practitioner - HospitalistPractitioner - Internal Medicine 8022297126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southcoast Physicians Group IncGroup PAC ID 0749171957, 875 clinicians

Practice addresses (Care Compare)

101 Page St
New Bedford, MA 02740-3464
Phone (508) 973-5919

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12363MTMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Physicians Group, Inc. CurrentSince Jun 22, 2015 Accepting new patients
Southcoast Physicians Group, Inc. Hospitalist CurrentSince Jun 22, 2015 Accepting new patients
Cogent Healthcare of Montana P C Hospitalist Past Accepting new patients
Southcoast Hospitals Group, Inc Past Accepting new patients
Southcoast Hospitals Group, Inc Past Accepting new patients

Locations

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

101 Page St
New Bedford, MA 02740
Phone (508) 961-5425

Interoperability endpoints

  • Direct secure messaging: ndallakoti19838@direct.southcoast.org

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 2

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": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587427200000",
    "number": "1841484359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5410 MARYLAND WAY",
            "address_2": "SUITE 300 COGENT HEALTHCARE",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "37027",
            "telephone_number": "615-377-5600",
            "fax_number": "615-373-5280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 26TH ST S",
            "address_2": "COGENT HEALTHCARE OF MONTANA, PC",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "59405",
            "telephone_number": "405-455-4690",
            "fax_number": "405-455-4691"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Page St",
            "address_purpose": "LOCATION",
            "city": "New Bedford",
            "state": "MA",
            "postal_code": "027403464",
            "country_code": "US",
            "telephone_number": "508-973-5919",
            "fax_number": "508-973-5916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DALLAKOTI",
        "first_name": "NISHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-29",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MA",
            "license": "261721",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MT",
            "license": "12363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ndallakoti19838@direct.southcoast.org",
            "affiliation": "N",
            "endpointDescription": "Southcoast Health Epic Direct Address",
            "address_1": "101 Page St",
            "city": "New Bedford",
            "state": "MA",
            "country_code": "US",
            "postal_code": "027403464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Great Falls, MT

Sources for this page

Verify at the official NPI Registry.