Mangalore Jairam Subbarao, MD is a medicare enrolled "Surgery" physician in Knox, Indiana. His current practice location is
104 E Culver Rd, Suite 102, Knox, Indiana. You can reach out to his office (for appointments etc.) via phone at
(574) 772-1580.
Mangalore Jairam Subbarao is licensed to practice in Indiana (license number 01041718) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1194771113.
Physician's Profile
Full Name | Mangalore Jairam Subbarao |
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Gender | Male |
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Speciality | Surgery |
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Location | 104 E Culver Rd, Knox, Indiana |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1194771113
- Provider Enumeration Date: 05/25/2006
- Last Update Date: 09/14/2021
Medicare PECOS Information:
- PECOS PAC ID: 3173528718
- Enrollment ID: I20061003000489
Medical Identifiers
Medical identifiers for Mangalore Jairam Subbarao such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1194771113 | NPI | - | NPPES |
100383520 | Medicaid | IN | |
000000682354 | Other | IN | ANTHEM |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208600000X | Surgery | 01041718 (Indiana) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mangalore Jairam Subbarao allows following entities to bill medicare on his behalf.
Entity Name | La Porte Clinic Company Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1568829224 PECOS PAC ID: 0446558357 Enrollment ID: O20160408001751 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mangalore Jairam Subbarao is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mangalore Jairam Subbarao, MD 2022 Kelle Dr, Chesterton, IN 46304-8708 Ph: (219) 326-2312 | Mangalore Jairam Subbarao, MD 104 E Culver Rd, Suite 102, Knox, IN 46534-2241 Ph: (574) 772-1580 |
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