Organization Active NPI

Sreenivasa R. Nakka, Inc

  • Gastroenterology Physician
  • Hemet, CA
National Provider Identifier
1003184979
Registry record updated Dec 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
SREENIVASA R. NAKKA, INC
Practice address
949 Calhoun PL
Ste a
Hemet, CA 92543-4403
Phone
(951) 929-1177
Fax
(951) 765-9111
NPI assigned
Dec 7, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2011

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

Authorized official

Name
Sreenivasa R Nakka, M.DNPI 1184666547
Title
President
Phone
(951) 929-1177

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

949 Calhoun PL
Ste a
Hemet, CA 92543-4403

Mailing address

949 Calhoun PL
Ste a
Hemet, CA 92543-4403
Phone (951) 929-1177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120104000640 CA Part B Supplier - Clinic/Group Practice 6709052269 Receives reassigned benefits from 2 practitioners
Practice locations: Hemet, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0944892Sreenivasa R Nakka, MD PC949 Calhoun Place Suite a, Hemet, CA 92543Certificate of waiverApr 21, 2028

National Provider Directory

National Provider Directory

Locations

949 Calhoun Pl
Ste B
Hemet, CA 92543
Phone (951) 929-1177

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1323216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323216000000",
    "number": "1003184979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "949 CALHOUN PL",
            "address_2": "STE A",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925434403",
            "telephone_number": "951-929-1177",
            "fax_number": "951-765-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "949 CALHOUN PL",
            "address_2": "STE A",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925434403",
            "telephone_number": "951-929-1177",
            "fax_number": "951-765-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SREENIVASA R. NAKKA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-07",
        "last_updated": "2011-12-07",
        "status": "A",
        "authorized_official_last_name": "NAKKA",
        "authorized_official_first_name": "SREENIVASA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-929-1177",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hemet, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.