Individual provider Active NPI

Srinivasu Kesa, MD

  • Obesity Medicine (Internal Medicine) Physician
  • Carmel, IN
National Provider Identifier
1003884404
Registry record updated Mar 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity Medicine (Internal Medicine) PhysicianTaxonomy code 207RB0002X
License
01056280 A Issued in IN
Practice address
3471 Muirfield Way
Carmel, IN 46032
Phone
(317) 850-7725
NPI assigned
Mar 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2015

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 01056280A IN
Obesity Medicine (Internal Medicine) Physician 207RB0002X 01056280 A IN Primary

Addresses

Primary practice location

3471 Muirfield Way
Carmel, IN 46032

Mailing address

3471 Muirfield Way
Ste. 400
Carmel, IN 46032-9375
Phone (317) 850-7725

Other identifiers 1

IdentifierTypeStateIssuer
200389120MedicaidIN

Other names 1

  • Kesa Srinivasu Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20080115000137 IN Practitioner - Internal MedicinePractitioner - Pediatric MedicinePractitioner - Emergency Medicine 4789765843

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01056280 AINMDObesity Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Major Hospital Past Accepting new patients
Care Group LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427241600000",
    "number": "1003884404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3471 MUIRFIELD WAY",
            "address_2": "STE. 400",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460329375",
            "telephone_number": "317-850-7725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3471 MUIRFIELD WAY",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "46032",
            "telephone_number": "317-850-7725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESA",
        "first_name": "SRINIVASU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2015-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01056280A",
            "primary": false
        },
        {
            "code": "207RB0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": "IN",
            "license": "01056280 A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200389120",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KESA",
            "last_name": "SRINIVASU",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Carmel, IN

Sources for this page

Verify at the official NPI Registry.