Individual provider Active NPI

Radha Chirumamilla, M.D.

  • Hospitalist Physician
  • Modesto, CA
National Provider Identifier
1003008590
Registry record updated Mar 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
A102181 Issued in CA
Practice address
600 Coffee Rd
Modesto, CA 95355-4201
Phone
(209) 524-1211
NPI assigned
Aug 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X A102181 CA Primary
Internal Medicine Physician 207R00000X A102181 CA

Addresses

Primary practice location

600 Coffee Rd
Modesto, CA 95355-4201

Mailing address

600 Coffee Rd
Modesto, CA 95355-4201
Phone (209) 524-1211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080314000515 CA Practitioner - Internal MedicinePractitioner - Hospitalist 4486739463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

1700 Coffee Rd
Modesto, CA 95355-2803
Phone (209) 526-4500

2800 L St
Sacramento, CA 95816-5616

Hospital & facility affiliations

  • Memorial Medical Center Hospital, Modesto, CA, CCN 050557
  • Emanuel Medical Center Hospital, Turlock, CA, CCN 050179

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A102181CAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Internal Medicine CurrentSince Mar 1, 2016 Accepting new patients
Sutter Valley Hospitals Past Accepting new patients

Locations

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301011200000",
    "number": "1003008590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554201",
            "telephone_number": "209-524-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554201",
            "telephone_number": "209-524-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIRUMAMILLA",
        "first_name": "RADHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-17",
        "last_updated": "2011-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A102181",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A102181",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.