Indira Kedlaya, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

44387 Issued in CO

Practice address

1600 N Grand Ave Ste 120
Pueblo, CO 81003-2755

Phone

(719) 545-9292

Fax

(719) 545-9191

NPI assigned

Dec 16, 2005

Last updated

Feb 11, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL, CA2 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

Specialty

Internal Medicine

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment Care Compare group NPD
• Advocate Health and Hospitals Corporation

  dba Advocate Medical Group

  • Multi-Specialty Clinic/Center
  • Oak Brook, IL
  • NPI 1700824455
  Medicare reassignment NPD
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment NPD
• Sunshine Medical Group PLLC

  • Internal Medicine Physician
  • Pueblo, CO
  • NPI 1770788770
  Authorized official Same address or phone
• Advocate Health and Hospitals Corporation

  dba Advocate Children's Hospital

  • Children's Hospital
  • Oak Lawn, IL
  • NPI 1508315516
  NPD
• Central PA Pharmacy LLC.

  dba patton pharmacy and v&s variety

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1154908929
  NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Redwood City, CA
  • NPI 1639252604
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Star Rehab Prof Physicians, LLC

  dba Star Rehab, LLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Pueblo West, CO
  • NPI 1922000421
  NPD (past)
• Star Rehab Therapy LLC

  • Physical Therapist
  • Pueblo, CO
  • NPI 1972564110
  NPD (past)
• Reedley Community Hospital

  dba Adventist Health Reedley - Corcoran

  • Rural Health Clinic/Center
  • Corcoran, CA
  • NPI 1881677292
  NPD (past)

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202688000000",
    "number": "1891771382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 N GRAND AVE STE 120",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032755",
            "telephone_number": "719-545-9292",
            "fax_number": "719-545-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N GRAND AVE STE 120",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032755",
            "telephone_number": "719-545-9292",
            "fax_number": "719-545-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEDLAYA",
        "first_name": "INDIRA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-16",
        "last_updated": "2008-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A067008",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "44387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33471231",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew James Keal, PT, DPT, CSCS
• Emily Anne Kearney, RDN
• Danielle Dalynn Keasling, FNP-C
• Carrie Fox Keating, MA, NCC, LPC
• John J Keating IV, DMD
• Harry R Keefe, MD
• Caitlin Keeley, PMHNP
• Sarah Elizabeth Keen, D.D.S.
• Sean Keenan, MD
• Frank Keller, PHARM.D.

• Internal Medicine Physician in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Internal Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.