Mahendra C Maru, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

33042 Issued in KY

Practice address

1930 E Parrish Ave
Owensboro, KY 42303-1443

Phone

(270) 689-1919

Fax

(270) 689-1990

NPI assigned

Jul 5, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Ohio Valley Nephrology Associates PSC

  • Specialist
  • Owensboro, KY
  • NPI 1952498347
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435017600000",
    "number": "1891792818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 E PARRISH AVE",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423031443",
            "telephone_number": "270-689-1919",
            "fax_number": "270-689-1990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 E PARRISH AVE",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423031443",
            "telephone_number": "270-689-1919",
            "fax_number": "270-689-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARU",
        "first_name": "MAHENDRA",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2015-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "KY",
            "license": "33042",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "33042",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200145790",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000067006",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64330426",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CJ7612",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000067006",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CJ7612",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca R. Martin, RN
• Sara Jane Martin, A.P.R.N.
• Sylvia G. Martin, LPCC
• William R Martin, MD
• Tiffany D Martindell, LMSW
• Ericka Joy Mason, PA
• Jeremiah Robert Mason, D.O.
• Jessica Mason, IECE
• Richard Lee Mason, CADC
• Pooja Ritesh Matadar, MD

• Nephrology Physician in Owensboro, KY
• Providers in Owensboro, KY by specialty
• Nephrology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.