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DR. BEULAH T. PENUMUDI M.D.
NPI 1750434486
Family Medicine in Fort Wayne, IN

Active since January 18, 2007PECOS Enrolled
2121 LAKE AVE, VA NORTHERN INDIANA HEALTH CARE SYSTEM, FORT WAYNE, IN 46805(260) 426-5431(260) 426-5431 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Beulah T. Penumudi M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. BEULAH T. PENUMUDI M.D. (NPI 1750434486) is an individual family medicine provider in Fort Wayne, Indiana, licensed in Nevada (11433) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1750434486
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. BEULAH T. PENUMUDICredential: M.D.
Location Address2121 LAKE AVE, VA NORTHERN INDIANA HEALTH CARE SYSTEMFort Wayne, IN 46805-5100
Mailing Address2121 Lake Ave, Va Northern Indiana Health Care SystemFort Wayne, IN 46805-5100 · (260) 426-5431 · Fax (260) 426-5431
Phone(260) 426-5431
Fax(260) 426-5431
Sole ProprietorNo
Enumeration DateJanuary 18, 2007
Last NPPES UpdateMarch 7, 2023
✔ NPI 1750434486 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NV · 11433
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
2121 LAKE AVE, Fort Wayne, IN 46805
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Other Identifiers 2

OtherCS12529NV · Pharmacy License
Other11433NV · Nevada Medical License

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Beulah T. Penumudi M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46805 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TAMMY MOEHLE
Registered Nurse (Oncology)
2121 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 426-5431
DR. CALEB ANDREW MOSSBURG PHARMD
Pharmacist
2121 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 426-5431
DR. ASHLEY M FULTON PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
2121 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 426-5431
HANNAH DULINSKY RN
Registered Nurse (Home Health)
2121 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 460-1445
DANIELLE SCHULTZ
Registered Nurse
2121 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 426-5431
DR. IAN H. COOK M.D.
Surgery
2121 LAKE AVE, VETERANS AFFAIRS MEDICAL CENTER
FORT WAYNE, IN 46805
Allen County (260) 426-5431
SCOTT KRUSE
Social Worker (Clinical)
2121 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 426-5431
MONICA JANE HALL
Registered Nurse (General Practice)
2121 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 456-0543

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Beulah Penumudi's NPI number?

The NPI number for Beulah Penumudi is 1750434486. It was assigned to this individual provider in the NPPES registry on January 18, 2007.

Where is Beulah Penumudi located?

Beulah Penumudi practices at 2121 Lake Ave VA Northern Indiana Health Care System, Fort Wayne, IN 46805. The listed phone number is (260) 426-5431.

What is Beulah Penumudi's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Beulah Penumudi enrolled in Medicare?

Yes. Beulah Penumudi is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Beulah Penumudi was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.