Individual provider Active NPI

Amareshwar Podugu, M.D.

  • Gastroenterology Physician
  • Canton, OH
National Provider Identifier
1972891737
Registry record updated May 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
35-130380 Issued in OH
Practice address
2726 Fulton Dr NW
Canton, OH 44718-3506
Phone
(330) 455-5011
NPI assigned
Jul 14, 2011
Last updated
May 12, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 35-130380 OH Primary

Addresses

Primary practice location

2726 Fulton Dr NW
Canton, OH 44718-3506

Mailing address

2726 Fulton Dr NW
Canton, OH 44718-3506
Phone (330) 455-5011

Other identifiers 1

IdentifierTypeStateIssuer
0236878MedicaidOH

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
I20170630001894 OH Practitioner - Gastroenterology 1254600430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastroenterology Specialists IncGroup PAC ID 5991604860, 18 clinicians

Practice addresses (Care Compare)

2726 Fulton Dr NW
Canton, OH 44718-3506
Phone (330) 455-5011

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.59 of 100Reported as group
Quality
83.4
Promoting interoperability
100
Improvement activities
40
Cost
78.58

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy186
Upper gastrointestinal (GI) endoscopy for acid reflux198

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-130380OHMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology Specialists Inc CurrentSince Jul 17, 2017 Accepting new patients
Gastroenterology Specialists Inc Single Specialty CurrentSince Jul 17, 2017 Accepting new patients

Locations

2726 Fulton Dr NW
Canton, OH 44718
Phone (330) 455-5011

Interoperability endpoints

  • FHIR API: https://a8580225-25d6-4812-a463-58e49a80f214.gastro.prod.fhir.ema-api.com/fhir/r4/

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 4

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": "1310601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1972891737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2726 FULTON DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447183506",
            "telephone_number": "330-455-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2726 FULTON DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447183506",
            "telephone_number": "330-455-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODUGU",
        "first_name": "AMARESHWAR",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-14",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "35-130380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0236878",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.