Individual provider Active NPI

Sridhar Chalasani, MD

  • Colon & Rectal Surgery Physician
  • Battle Creek, MI
National Provider Identifier
1063494607
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
SC077498 Issued in MI
Practice address
3770 Capital Ave SW
Ste a
Battle Creek, MI 49015-9411
Phone
(269) 441-1771
Fax
(269) 441-1773
NPI assigned
Nov 18, 2005
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X SC077498 MI Primary

Addresses

Primary practice location

3770 Capital Ave SW
Ste a
Battle Creek, MI 49015-9411

Mailing address

3770 Capital Ave SW
Suite a
Battle Creek, MI 49015-9411
Phone (269) 441-1771

Other identifiers 11

IdentifierTypeStateIssuer
280001089OtherRAILROAD MEDICARE
4408297MedicaidMI
0105542OtherCIGNA
135082OtherGREAT LAKES
7512375OtherAETNA
1063494607MedicaidMI
1430026OtherPHYSICIANS HEALTH PLAN
383125785105OtherCOMMUNITY CHOICE MICHIGAN
P116414OtherBLUE CARE NETWORK
134398OtherPREFERRED CHOICES
1417961137OtherMIBCBS BRONSON

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20101103000085 MI Practitioner - Colorectal Surgery (Proctology) 6709967748 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bronson Methodist HospitalGroup PAC ID 0244148633, 721 clinicians

Practice addresses (Care Compare)

601 John St
Suite M 124
Kalamazoo, MI 49007-5377
Phone (269) 341-8383

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.43 of 100Reported as group
Quality
75.38
Promoting interoperability
100
Improvement activities
40
Cost
79.38

Merit-based Incentive Payment System (MIPS)

Final score
93.89 of 100Reported as group
Quality
95.63
Promoting interoperability
100
Improvement activities
40
Cost
84

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy124
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SC077498MIMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bronson Lakeview Hospital CurrentSince Jan 8, 2019 Accepting new patients
Bronson Methodist Hospital CurrentSince Dec 1, 2012 Accepting new patients
Bronson Lakeview Hospital CurrentSince Jan 8, 2019 Accepting new patients
Bronson Lakeview Hospital Current Accepting new patients

Locations

3770 Capital Ave SW
Ste A
Battle Creek, MI 49015
Phone (269) 441-1771

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

601 John St
Ste M452
Kalamazoo, MI 49007
Phone (269) 341-6022

408 Hazen St
Paw Paw, MI 49079
Phone (269) 341-8481

451 Health Pkwy
Paw Paw, MI 49079
Phone (269) 655-1725

Interoperability endpoints

  • Direct secure messaging: direct@direct.bronsonhg.org
  • Direct secure messaging: schalasani10395@direct.bronsonhg.org

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Bronson Lakeview HospitalPaw Paw, MI, CCN 231332 Hospital Corporate Officer Jan 1, 2020
Bronson South Haven HospitalSouth Haven, MI, CCN 23U085 Hospital Corporate Officer Jan 1, 2020
Bronson Lakeview HospitalPaw Paw, MI, CCN 23Z332 Hospital Corporate Officer Jan 1, 2020
Bronson Lakeview Family Care-Paw PawPaw Paw, MI, CCN 238601 Rural health clinic Corporate Officer Jan 1, 2020

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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

Hospital & facility affiliations 4

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": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1063494607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3770 CAPITAL AVE SW",
            "address_2": "SUITE A",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490159411",
            "telephone_number": "269-441-1771",
            "fax_number": "269-441-1773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3770 CAPITAL AVE SW",
            "address_2": "STE A",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490159411",
            "telephone_number": "269-441-1771",
            "fax_number": "269-441-1773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHALASANI",
        "first_name": "SRIDHAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "MI",
            "license": "SC077498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "280001089",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4408297",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0105542",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT LAKES",
            "identifier": "135082",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7512375",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063494607",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIANS HEALTH PLAN",
            "identifier": "1430026",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY CHOICE MICHIGAN",
            "identifier": "383125785105",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "P116414",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CHOICES",
            "identifier": "134398",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS BRONSON",
            "identifier": "1417961137",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Battle Creek, MI

Sources for this page

Verify at the official NPI Registry.