NPIMap

Individual provider Active NPI

Anuradha Divakaruni, M.D.

  • Interventional Cardiology Physician
  • Munster, IN
National Provider Identifier
1902936586
Registry record updated Sep 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
01042616 Issued in IN
Practice address
1730 45TH Ave
Munster, IN 46321-3915
Phone
(219) 836-9677
Fax
(219) 836-0688
NPI assigned
Mar 6, 2007
Last updated
Sep 15, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Cardiology Physician 207UN0901X 01042616 IN
Interventional Cardiology Physician 207RI0011X 01042616 IN Primary

Addresses

Primary practice location

1730 45TH Ave
Munster, IN 46321-3915

Mailing address

1730 45TH Ave
Munster, IN 46321-3915
Phone (219) 836-9677

Other identifiers 3

IdentifierTypeStateIssuer
100382300MedicaidIN
90000999OtherILBCBSIL
000000320576OtherINANTHEM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040623001249 IN Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 1557346434 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiac Care Consultants PCGroup PAC ID 6305820580, 2 clinicians

Practice addresses (Care Compare)

4321 Fir St
East Chicago, IN 46312-3049
Phone (219) 836-9677

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01042616INMDNuclear Cardiology Physician

Interoperability endpoints

  • Direct secure messaging: adivakaruni64135@direct.franciscanalliance.org
  • Direct secure messaging: anuradhadivakaruni@canwipc.allscriptsdirect.net

Organizations & group practices 1

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.

Hospital & facility affiliations 9

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": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284508800000",
    "number": "1902936586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 45TH AVE",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463213915",
            "telephone_number": "219-836-9677",
            "fax_number": "219-836-0688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 45TH AVE",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463213915",
            "telephone_number": "219-836-9677",
            "fax_number": "219-836-0688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVAKARUNI",
        "first_name": "ANURADHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2010-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "IN",
            "license": "01042616",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IN",
            "license": "01042616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100382300",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSIL",
            "identifier": "90000999",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000320576",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.