Shanu Kondamuri, MD | |
8840 Calumet Ave, Suite 103, Munster, IN 46321-2545 | |
(219) 836-7246 | |
(219) 836-6454 |
Full Name | Shanu Kondamuri |
---|---|
Gender | Male |
Speciality | Pain Management |
Experience | 38 Years |
Location | 8840 Calumet Ave, Munster, Indiana |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1497754287 | NPI | - | NPPES |
01045126A | Other | IL | BCBS OF ILLINOIS |
01045126A | Other | IN | LICENSE NUMBER |
200111560A | Medicaid | IN | |
050043847 | Other | GA | MEDICARE RAILROAD |
000000330844 | Other | IN | BLUE CROSS BLUE SHIELD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208VP0014X | Pain Medicine - Interventional Pain Medicine | 01045126A (Indiana) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
St Mary Medical Center Inc | Hobart, IN | Hospital |
Community Hospital | Munster, IN | Hospital |
Franciscan Health Crown Point | Crown point, IN | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Community Care Network Inc | 3678737012 | 346 |
Midwest Pain Management Centers,llc | 5496654618 | 9 |
Entity Name | Midwest Pain Management Centers,llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1962401745 PECOS PAC ID: 5496654618 Enrollment ID: O20040112000257 |
Entity Name | Pain Management Specialists, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1881693562 PECOS PAC ID: 9032134770 Enrollment ID: O20051011001027 |
Entity Name | Community Care Network Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1457610487 PECOS PAC ID: 3678737012 Enrollment ID: O20120614000331 |
Mailing Address | Practice Location Address |
---|---|
Shanu Kondamuri, MD 8840 Calumet Ave, Suite 103, Munster, IN 46321-2545 Ph: (219) 836-7246 | Shanu Kondamuri, MD 8840 Calumet Ave, Suite 103, Munster, IN 46321-2545 Ph: (219) 836-7246 |
Miss Kathryn Lillian Trojan, FNP-BC Pain Medicine Medicare: Accepting Medicare Assignments Practice Location: 8840 Calumet Ave, Suite 103, Munster, IN 46321 Phone: 219-836-7246 Fax: 219-836-6454 | |
Satish Dasari, M.D. Pain Medicine Medicare: Accepting Medicare Assignments Practice Location: 8840 Calumet Ave, Suite 103, Munster, IN 46321 Phone: 219-836-7246 Fax: 219-836-6454 | |
Ravi Kanakamedala, M.D. Pain Medicine Medicare: Not Enrolled in Medicare Practice Location: 8840 Calumet Ave, Suite 103, Munster, IN 46321 Phone: 219-836-7246 Fax: 219-836-6454 |