Lavanya Boddu, MD | |
2512 Hurst Dr Ste 120, Mattoon, IL 61938-9200 | |
(217) 258-7590 | |
(217) 258-3686 |
Full Name | Lavanya Boddu |
---|---|
Gender | Female |
Speciality | Emergency Medicine |
Experience | 24 Years |
Location | 2512 Hurst Dr Ste 120, Mattoon, Illinois |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1851503833 | NPI | - | NPPES |
036121313 | Other | IL | BLUE SHIELD |
036121313-1 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | 036-121313 (Illinois) | Secondary |
207Q00000X | Family Medicine | 036121313 (Illinois) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
The Carle Foundation Hospital | Urbana, IL | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Carle Health Care Incorporated | 3577515774 | 799 |
City Medical Of Upper East Side Pllc | 0648465039 | 737 |
Entity Name | Midwest Emergency Department Specialists Ltd |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1245263367 PECOS PAC ID: 5193627727 Enrollment ID: O20040123000845 |
Entity Name | Hoopeston Community Memorial Hospital |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1366480873 PECOS PAC ID: 3577456037 Enrollment ID: O20040210000011 |
Entity Name | Carle Health Care Incorporated |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1154653947 PECOS PAC ID: 3577515774 Enrollment ID: O20100513000829 |
Entity Name | Cep America-illinois Hospitalists, Llp |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1841613403 PECOS PAC ID: 3274765904 Enrollment ID: O20140411001788 |
Entity Name | Carle West Physician Group Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1467074138 PECOS PAC ID: 8921420308 Enrollment ID: O20200613000147 |
Mailing Address | Practice Location Address |
---|---|
Lavanya Boddu, MD 611 W Park St, Fapc, Urbana, IL 61801 Ph: (217) 789-1403 | Lavanya Boddu, MD 2512 Hurst Dr Ste 120, Mattoon, IL 61938-9200 Ph: (217) 258-7590 |
Dr. Dominic Perrino, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1000 Health Center Dr, Mattoon, IL 61938 Phone: 217-238-4325 Fax: 217-348-4290 | |
Andrew Robert Gage, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 101 Coles Centre Dr, Mattoon, IL 61938 Phone: 217-234-5110 | |
Jagan Mohan Reddy Bokka I, M.D Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1000 Health Center Dr, Mattoon, IL 61938 Phone: 217-238-4325 Fax: 217-348-4290 | |
Robert Wochner, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1005 Health Center Drive, Suite 103, Mattoon, IL 61938 Phone: 217-258-4051 Fax: 217-258-4063 | |
Kristine Ross Carpenter, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2512 Hurst Dr., Mattoon, IL 61938 Phone: 217-258-5900 Fax: 217-258-3686 | |
Margaret Louisa Tate, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2512 Hurst Dr Ste 120, Mattoon, IL 61938 Phone: 217-258-5900 Fax: 217-258-3686 | |
Dr. Dawn Miesner, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2512 Hurst Dr, Ste 120, Mattoon, IL 61938 Phone: 217-258-5900 Fax: 217-258-5904 |