Individual provider Active NPI

Venu Vadlamudi, M.D.

  • Diagnostic Radiology Physician
  • South Bend, IN
National Provider Identifier
1952508699
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
72704 Issued in CT
Practice address
100 Navarre PL Ste 5500
South Bend, IN 46601-1172
Phone
(574) 647-5200
Fax
(574) 647-5210
NPI assigned
Jun 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

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

Specialties & licenses 14

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X C2086 KY
Vascular & Interventional Radiology Physician 2085R0204X U7369 TX
Vascular & Interventional Radiology Physician 2085R0204X 4301090594 MI
Vascular & Interventional Radiology Physician 2085R0204X 01087961A IN
Vascular & Interventional Radiology Physician 2085R0204X 72704 CT
Vascular & Interventional Radiology Physician 2085R0204X 0101255868 VA
Vascular & Interventional Radiology Physician 2085R0204X 58985 TN
Vascular & Interventional Radiology Physician 2085R0204X D0093992 MD
Vascular & Interventional Radiology Physician 2085R0204X 036.167487 IL
Vascular & Interventional Radiology Physician 2085R0204X 295371 MA
Vascular & Interventional Radiology Physician 2085R0204X 71773 AZ
Diagnostic Radiology Physician 2085R0202X 72704 CT Primary
Vascular & Interventional Radiology Physician 2085R0204X 26716 MS
Vascular & Interventional Radiology Physician 2085R0204X E-112315 AR

Addresses

Primary practice location

100 Navarre PL Ste 5500
South Bend, IN 46601-1172

Mailing address

65 N Farms Rd
Avon, CT 06001-3018
Phone (703) 888-8130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC, IN, MD, KY, CT, VT7 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 7

Enrollment IDStateProvider typePAC IDDetails
I20140528000040 VA Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 2062656903 Reassigns benefits to 3 organizations
I20140715001513 DC Practitioner - Diagnostic Radiology 2062656903 Reassigns benefits to 2 organizations
I20220720001202 IN Practitioner - Interventional Radiology 2062656903 Reassigns benefits to 1 organization
I20220823000037 MD Practitioner - Diagnostic Radiology 2062656903 Reassigns benefits to 1 organization
I20240410003466 KY Practitioner - Radiation Oncology 2062656903 Reassigns benefits to 1 organization
I20240524002256 CT Practitioner - Diagnostic Radiology 2062656903 Reassigns benefits to 4 organizations
I20241203000969 VT Practitioner - Interventional Radiology 2062656903 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beacon Medical Group IncGroup PAC ID 1254243306, 575 clinicians
Advanced Imaging Specialists LLCGroup PAC ID 9234676164, 47 clinicians

Practice addresses (Care Compare)

100 Navarre PL
5500 BMG Interventional Radiology
South Bend, IN 46601-1172
Phone (574) 647-5200

114 Woodland St
Hartford, CT 06105-1208
Phone (860) 714-4000

615 N Michigan St
South Bend, IN 46601-1033

615 N Michigan St FL
South Bend, IN 46601-1033

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72704CTMDDiagnostic Radiology Physician
E-112315ARMDVascular & Interventional Radiology Physician
71773AZMDVascular & Interventional Radiology Physician
036.167487ILMDVascular & Interventional Radiology Physician
295371MAMDVascular & Interventional Radiology Physician
0101255868VAMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Imaging LLC Diagnostic Radiology CurrentSince Apr 30, 2024 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Jun 11, 2024 Accepting new patients
Beacon Medical Group, Inc. Vascular & Interventional Radiology CurrentSince Jul 11, 2022 Accepting new patients
Northern Virginia Radiology Consultants, PLLC Diagnostic Radiology CurrentSince Mar 1, 2022 Accepting new patients
Concord Radiology PLLC Diagnostic Radiology CurrentSince Feb 20, 2024 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Mar 1, 2024 Accepting new patients
Beacon Medical Group, Inc. Current Accepting new patients
Ut Regional One Physicians Inc Diagnostic Radiology CurrentSince Nov 18, 2019 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Jun 11, 2024 Accepting new patients
Advanced Imaging Specialists, LLC Diagnostic Radiology CurrentSince Sep 15, 2024 Accepting new patients
Ut Regional One Physicians Inc CurrentSince Nov 18, 2019 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Mar 1, 2024 Accepting new patients
University of Virginia Physicians Group CurrentSince May 1, 2022 Accepting new patients
University of Vermont Medical Center Inc CurrentSince Nov 1, 2024 Accepting new patients
Baptist Health Medical Group Inc Current Accepting new patients
Beacon Medical Group Inc CurrentSince Jul 11, 2022 Accepting new patients
Medstar Medical Group Radiology, LLC Diagnostic Radiology CurrentSince Aug 1, 2022 Accepting new patients

Locations

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

34 Maple St
Norwalk, CT 06850
Phone (203) 852-2000

6913 N Main St
Granger, IN 46530
Phone (574) 647-1500

3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129

615 N Michigan St
Fl 1
South Bend, IN 46601
Phone (574) 647-1100

615 N Michigan St
South Bend, IN 46601
Phone (574) 647-1000

100 Navarre Pl
Ste 5500
South Bend, IN 46601
Phone (574) 647-5200

1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521

4071 Tates Creek Centre Dr
Ste 202
Lexington, KY 40517
Phone (859) 260-4390

5200 Commerce Crossings Dr
Fl 3
Louisville, KY 40229
Phone (502) 253-4924

201 E University Pkwy
Baltimore, MD 21218
Phone (410) 554-2651

3001 S Hanover St
Brooklyn Park, MD 21225
Phone (410) 350-3200

877 Jefferson Ave
Memphis, TN 38103
Phone (901) 448-5893

6215 Humphreys Blvd
Ste 201
Memphis, TN 38120
Phone (901) 866-8085

575 Hill Country Dr
Ste 101
Kerrville, TX 78028
Phone (830) 258-7090

575 Hill Country Dr
Ste 202
Kerrville, TX 78028
Phone (830) 258-6237

1602 Avenue Q
Lubbock, TX 79401
Phone (469) 809-6712

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

1215 Lee St
Fl 1
Charlottesville, VA 22908
Phone (434) 924-9400

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

1850 Town Center Pkwy
Reston, VA 20190
Phone (703) 478-0922

111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

Interoperability endpoints

  • Direct secure messaging: vvadlamudi3326691@direct.trinity-health.org

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 10

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": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1952508699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 N FARMS RD",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013018",
            "telephone_number": "703-888-8130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NAVARRE PL STE 5500",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011172",
            "telephone_number": "574-647-5200",
            "fax_number": "574-647-5210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VADLAMUDI",
        "first_name": "VENU",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-27",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "KY",
            "license": "C2086",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TX",
            "license": "U7369",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MI",
            "license": "4301090594",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "IN",
            "license": "01087961A",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CT",
            "license": "72704",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "VA",
            "license": "0101255868",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TN",
            "license": "58985",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MD",
            "license": "D0093992",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "IL",
            "license": "036.167487",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MA",
            "license": "295371",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "AZ",
            "license": "71773",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CT",
            "license": "72704",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MS",
            "license": "26716",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "AR",
            "license": "E-112315",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.