NPIMap

Individual provider Active NPI

Sharmila Suri Mohanram, MD

  • Behavioral Neurology & Neuropsychiatry Physician
  • Jefferson City, MO
National Provider Identifier
1053690669
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavioral Neurology & Neuropsychiatry PhysicianTaxonomy code 2084B0040X
License
2015004633 Issued in MO
Practice address
1125 Madison St
Capital Region Physicians
Jefferson City, MO 65101-5227
Phone
(573) 632-5560
NPI assigned
Aug 12, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 2011017409 MO
Behavioral Neurology & Neuropsychiatry Physician 2084B0040X 2015004633 MO Primary

Addresses

Primary practice location

1125 Madison St
Capital Region Physicians
Jefferson City, MO 65101-5227

Mailing address

PO Box 802843
Kansas City, MO 64180-2843

Other practice location 1

3801 S National Ave Ste 900
Springfield, MO 65807-5210
Phone (417) 875-3000

Other identifiers 2

IdentifierTypeStateIssuer
200022885MedicaidMO
2015004633OtherMOSTATE LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150716002204 MO Practitioner - NeuropsychiatryPractitioner - Neurology 4688818487 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neuropsychiatry
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lester E Cox Medical CentersGroup PAC ID 1254248917, 336 clinicians

Practice addresses (Care Compare)

1125 Madison St
Jefferson City, MO 65101-5227
Phone (573) 635-7141

3801 S National
Suite 900
Springfield, MO 65807-5210
Phone (417) 875-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.52 of 100Reported as group
Quality
61.64
Promoting interoperability
100
Improvement activities
40
Cost
76.77

Merit-based Incentive Payment System (MIPS)

Final score
80.23 of 100Reported as group
Quality
58.17
Promoting interoperability
100
Improvement activities
40
Cost
75.92

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2011017409MOMDGeneral Acute Care Hospital

Practice roles

OrganizationSpecialtyStatusNew patients
Lester E Cox Medical Centers Current Accepting new patients
Alliance Physicians Inc Current Accepting new patients
The Curators of the University of Missouri CurrentSince Jan 1, 2024 Accepting new patients
Lester E Cox Medical Centers CurrentSince Oct 1, 2022 Accepting new patients
Curators of the University of Missouri CurrentSince Jan 1, 2024 Accepting new patients
Ozarks Medical Center General Acute Care Hospital Past Accepting new patients
Capital Region Medical Center Past Accepting new patients
Lester E Cox Medical Centers Past Accepting new patients

Locations

1 Hospital Dr
Columbia, MO 65212
Phone (573) 882-2568

1125 Madison St
Jefferson Cty, MO 65101
Phone (573) 632-5000

3800 S National Ave
Ste 400
Springfield, MO 65807
Phone (417) 269-9482

3801 S National Ave
Ste 900
Springfield, MO 65807
Phone (417) 269-2710

1000 E Primrose St
Ste 360
Springfield, MO 65807
Phone (417) 269-4037

1001 E Primrose St
Springfield, MO 65807
Phone (417) 875-3434

901 Kidwell Dr
Versailles, MO 65084
Phone (573) 378-4666

Networks

  • IA HMO

Interoperability endpoints

  • Direct secure messaging: ssurimohanram817690@direct.ketteringhealth.org

Organizations & group practices 8

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 10

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": "1313107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1053690669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 802843",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641802843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 MADISON ST",
            "address_2": "CAPITAL REGION PHYSICIANS",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651015227",
            "telephone_number": "573-632-5560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3801 S National Ave Ste 900",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658075210",
            "country_code": "US",
            "telephone_number": "417-875-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SURI MOHANRAM",
        "first_name": "SHARMILA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-12",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MO",
            "license": "2011017409",
            "primary": false
        },
        {
            "code": "2084B0040X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": "MO",
            "license": "2015004633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200022885",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2015004633",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.