Individual provider Active NPI

Anil Kumar Chagarlamudi, MD

  • Interventional Cardiology Physician
  • Houma, LA
National Provider Identifier
1952308959
Registry record updated Oct 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
15183R Issued in LA
Practice address
225 Dunn St
Houma, LA 70360-4413
Phone
(985) 876-0300
Fax
(985) 872-0317
NPI assigned
Jul 5, 2005
Last updated
Oct 19, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 15183R LA
Interventional Cardiology Physician 207RI0011X 15183R LA Primary

Addresses

Primary practice location

225 Dunn St
Houma, LA 70360-4413

Mailing address

PO Box 4176
Houma, LA 70361-4176
Phone (985) 876-0300

Other identifiers 2

IdentifierTypeStateIssuer
1159409MedicaidLA
P00078777OtherLARR MEDCIARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20031118000942 LA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 5698689107 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiovascular Institute of the South, LLCGroup PAC ID 3779497441, 145 clinicians

Practice addresses (Care Compare)

225 Dunn St
Houma, LA 70360-4413
Phone (985) 876-0300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting22
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15183RLAMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thibodaux Regional Network Development Corporation Current Accepting new patients
Thibodaux Regional Network Development Corporation CurrentSince Jan 16, 2023 Accepting new patients
Thibodaux Regional Network Development Corporation Cardiovascular Disease CurrentSince Jan 16, 2023 Accepting new patients

Locations

602 N Acadia Rd
Thibodaux, LA 70301
Phone (985) 493-4544

604 N Acadia Rd
Ste 409
Thibodaux, LA 70301
Phone (985) 446-9785

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445212800000",
    "number": "1952308959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4176",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703614176",
            "telephone_number": "985-876-0300",
            "fax_number": "985-872-0317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 DUNN ST",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703604413",
            "telephone_number": "985-876-0300",
            "fax_number": "985-872-0317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAGARLAMUDI",
        "first_name": "ANIL",
        "middle_name": "KUMAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2015-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "LA",
            "license": "15183R",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "LA",
            "license": "15183R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1159409",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDCIARE",
            "identifier": "P00078777",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houma, LA

Sources for this page

Verify at the official NPI Registry.