| Padmaja Chalasani, MD | |
|
Grand Lake Primary Care At St Marys, 1140 S Knoxville Ave Ste A, Saint Marys, OH 45885-2609 | |
| (419) 394-9959 | |
| (419) 394-0255 |
| Full Name | Padmaja Chalasani |
|---|---|
| Gender | Female |
| Speciality | Internal Medicine |
| Experience | 36 Years |
| Location | Grand Lake Primary Care At St Marys, Saint Marys, Ohio |
| 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 |
|---|---|---|---|
| 1023113693 | NPI | - | NPPES |
| 9934723 | Other | OH | ORGANIZATIONAL MEDICARE PTAN |
| H348972 | Other | OH | MEDICARE PTAN |
| 2079076 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 35.074537 (Ohio) | Secondary |
| 207R00000X | Internal Medicine | 35.074537 (Ohio) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Grand Lake Home Health | St marys, OH | Home health agency |
| Grand Lake Health System | Saint marys, OH | Hospital |
| Mercer County Joint Township Community Hospital | Coldwater, OH | Hospital |
| Mercy Health-st Rita's Medical Center | Lima, OH | Hospital |
| Lima Memorial Health System | Lima, OH | Hospital |
| Otterbein St Marys Retirement Community | St marys, OH | Nursing home |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Jtdm Family Practice Llc | 2163415837 | 48 |
| Joint Township District Memorial Hospital | 3870491590 | 40 |
| Entity Name | Joint Township District Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639133002 PECOS PAC ID: 3870491590 Enrollment ID: O20031219000416 |
| Entity Name | Jtdm Family Practice Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1184652539 PECOS PAC ID: 2163415837 Enrollment ID: O20040407000863 |
| Mailing Address | Practice Location Address |
|---|---|
| Padmaja Chalasani, MD 200 Saint Clair Ave, Saint Marys, OH 45885-2400 Ph: (419) 300-1129 | Padmaja Chalasani, MD Grand Lake Primary Care At St Marys, 1140 S Knoxville Ave Ste A, Saint Marys, OH 45885-2609 Ph: (419) 394-9959 |