Active NPI
Vinod A Pallekonda, MD
- Family Medicine Physician
- Indianapolis, IN
National Provider Identifier
1992770978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01059054A
- Practice address
- 9560 E 59TH St
Indianapolis, IN 46216-1010 - Phone
- (317) 621-1700
- Fax
- (317) 621-1711
- NPI assigned
- Feb 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01059054A | IN | Primary |
Addresses
Primary practice location
9560 E 59TH St
Indianapolis, IN 46216-1010
Mailing address
5340 Woburn Dr
Indianapolis, IN 46250-2742
Phone (317) 331-3358
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000344907 | Other | IN | ANTHEM |
| 200930550 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200418000354 | IN | Order and Referring Only - Family Practice | 5991773061 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Major Hospital | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556236800000",
"number": "1992770978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5340 WOBURN DR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462502742",
"telephone_number": "317-331-3358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9560 E 59TH ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462161010",
"telephone_number": "317-621-1700",
"fax_number": "317-621-1711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALLEKONDA",
"first_name": "VINOD",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-22",
"last_updated": "2019-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "01059054A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000344907",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200930550",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.