Sruthi Domalapally

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95011027 Issued in CA

Practice address

65 N 14TH St
San Jose, CA 95112-6207

Phone

(408) 279-1400

NPI assigned

Apr 2, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Integrated Pain Management Medical Group, Inc.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Walnut Creek, CA
  • NPI 1922198779
  Medicare reassignment NPD

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

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554163200000",
    "number": "1033671748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 VISTA MONTANA APT 3215",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951342377",
            "telephone_number": "240-812-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 N 14TH ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951126207",
            "telephone_number": "408-279-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMALAPALLY",
        "first_name": "SRUTHI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-02",
        "last_updated": "2019-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95011027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maryam Dolatshahi, M.D.
• Calista Papa Dollaga
• Mariama Dolleh
• Jana Dolnikova, MD
• Marina Dols
• Janet Fishstrom Dombro, IBCLC
• Stephen N. Dombro, D.D.S.
• Jennifer Domingo-Mihalko, MD
• Kristian Noel Domingo
• Blanca Dominguez, B.A.

• Nurse Practitioner in San Jose, CA
• Providers in San Jose, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.