Individual provider Active NPI

Radha Andukuri, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Omaha, NE
National Provider Identifier
1992921779
Registry record updated Aug 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
24304 Issued in NE
Practice address
7831 Chicago CT
Omaha, NE 68114-3654
Phone
(402) 561-2740
Fax
(402) 561-2738
NPI assigned
Apr 18, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 7

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physicians Clinic Inc 557 clinicians

Practice addresses (Care Compare)

7831 Chicago CT
Omaha, NE 68114-3654
Phone (402) 561-2740

933 E Pierce St
Methodist Jennie Edmundson
Council Bluffs, IA 51503-4626
Phone (712) 396-6000

Hospital & facility affiliations

  • The Nebraska Methodist Hospital Hospital, Omaha, NE, CCN 280040
  • Myrtue Medical Center Hospital, Harlan, IA, CCN 161374
  • Methodist Jennie Edmundson Hospital, Council Bluffs, IA, CCN 160047
  • Methodist Fremont Health Hospital, Fremont, NE, CCN 280077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20071204000599 NE Practitioner - EndocrinologyPractitioner - Internal Medicine 1850480401 Reassigns benefits to 1 organization
I20120816000577 IA Practitioner - HospitalistPractitioner - Internal Medicine 1850480401 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD39269IAMDInternal Medicine Physician
24304NEMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska Methodist Hospital Current Accepting new patients
Physicians Clinic Inc Internal Medicine CurrentSince Aug 31, 2019 Accepting new patients
Diabetes Supply Center of the Midlands LLC PastSince Jun 7, 2017 Accepting new patients

Locations

1 Edmundson Pl
Ste 310
Council Bluffs, IA 51503
Phone (712) 328-1801

800 Mercy Dr
Council Bluffs, IA 51503
Phone (712) 328-5000

1 Edmundson Pl
Council Bluffs, IA 51503
Phone (712) 396-4000

800 Mercy Dr
Ste 220
Council Bluffs, IA 51503
Phone (712) 388-2660

933 E Pierce St
Council Bluffs, IA 51503
Phone (712) 328-6000

301 N 27th St
Ste 2
Norfolk, NE 68701
Phone (402) 644-7654

825 S 169th St
Omaha, NE 68118
Phone (402) 354-3370

7831 Chicago Ct
Omaha, NE 68114
Phone (402) 354-1230

825 S 169th St
Fl 3
Omaha, NE 68118
Phone (402) 354-5451

10060 Regency Cir
Omaha, NE 68114
Phone (402) 354-1405

Interoperability endpoints

  • Direct secure messaging: randukuri170966@uihcdirect.org
  • Direct secure messaging: radha.andukuri@direct.nmhs.org

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 24304 NE
Internal Medicine Physician 207R00000X MD39269 IA
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 24304 NE Primary

Addresses

NPPES NPI Registry

Primary practice location

7831 Chicago CT
Omaha, NE 68114-3654

Mailing address

PO Box 3755
Omaha, NE 68103-0755
Phone (402) 354-2100

Other identifiers 3

NPPES NPI Registry
IdentifierTypeStateIssuer
1992921779MedicaidIA
10025277100MedicaidNE
10026480118MedicaidNE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 30, 2019.

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567123200000",
    "number": "1992921779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3755",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681030755",
            "telephone_number": "402-354-2100",
            "fax_number": "402-354-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7831 CHICAGO CT",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143654",
            "telephone_number": "402-561-2740",
            "fax_number": "402-561-2738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDUKURI",
        "first_name": "RADHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2019-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "24304",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "MD39269",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NE",
            "license": "24304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992921779",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025277100",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026480118",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.