Individual provider Active NPI

Dheeraj Muddasani, MD

  • Neuroradiology Physician
  • Dublin, OH
National Provider Identifier
1912496845
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
35150289 Issued in OH
Practice address
5475 Rings Rd Ste 300
Dublin, OH 43017-7537
Phone
(614) 210-1885
NPI assigned
May 7, 2018
Last updated
Apr 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Neuroradiology Physician 2085N0700X 35150289 OH Primary

Addresses

Primary practice location

5475 Rings Rd Ste 300
Dublin, OH 43017-7537

Mailing address

1600 Euclid Ave Apt 1905
Cleveland, OH 44115-2156

Other practice location 1

11100 Euclid Ave
Cleveland, OH 44106-1716
Phone (216) 541-1758

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20241102000380 OH Practitioner - Diagnostic Radiology 4385177062 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tri-County Radiologists IncGroup PAC ID 0840241907, 25 clinicians
Radiology IncGroup PAC ID 1658274543, 56 clinicians

Practice addresses (Care Compare)

1600 Euclid Ave
Apt 1905
Cleveland, OH 44115-2156
Phone (740) 348-5545

793 W State St
Columbus, OH 43222-1551
Phone (614) 234-5100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35150289OHMDNeuroradiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Inc CurrentSince Aug 10, 2024 Accepting new patients

Locations

793 W State St
Columbus, OH 43222
Phone (614) 234-1862

Dept L647
Columbus, OH 43260

5475 Rings Rd
Ste 300
Dublin, OH 43017
Phone (614) 451-2151

10330 Sawmill Pkwy
Ste 500
Powell, OH 43065
Phone (614) 234-0522

Interoperability endpoints

  • Direct secure messaging: dmuddasani3395745@direct.trinity-health.org

Organizations & group practices 2

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 6

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": "1525651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1912496845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 EUCLID AVE APT 1905",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441152156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5475 RINGS RD STE 300",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430177537",
            "telephone_number": "614-210-1885"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11100 Euclid Ave",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441061716",
            "country_code": "US",
            "telephone_number": "216-541-1758",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUDDASANI",
        "first_name": "DHEERAJ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-07",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "OH",
            "license": "35150289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, OH

Sources for this page

Verify at the official NPI Registry.