NPIMap

Individual provider Active NPI

Divya Sree Madhuramthakam, MD

  • Internal Medicine Physician
  • South Euclid, OH
National Provider Identifier
1073017943
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.142344 Issued in OH
Practice address
1611 S Green Rd
South Euclid, OH 44121-4129
Phone
(216) 237-5011
NPI assigned
Mar 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 35.142344 OH Primary

Addresses

Primary practice location

1611 S Green Rd
South Euclid, OH 44121-4129

Mailing address

1058 Riverview Dr
Macedonia, OH 44056-1622
Phone (330) 957-1742

Other practice location 1

327 Beach 19th St
Far Rockaway, NY 11691-4423
Phone (718) 869-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20210730002954 OH Practitioner - Internal Medicine 2668875444 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Primary Care Practices IncGroup PAC ID 3072417534, 1,071 clinicians

Practice addresses (Care Compare)

158 W Main Rd
Conneaut, OH 44030-2039

1611 S Green Rd
Suite 065
South Euclid, OH 44121-4129
Phone (216) 383-0100

Hospital & facility affiliations

  • University Hospital Home Care Services, Inc Home health agency, Warrensville HTS, OH, CCN 367424
  • Uh Cleveland Medical Center Hospital, Cleveland, OH, CCN 360137
  • University Hospitals Ahuja Medical Center Hospital, Beachwood, OH, CCN 360359
  • Lake Health Hospital, Concord, OH, CCN 360098

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc Current Accepting new patients
University Primary Care Practices Inc Internal Medicine CurrentSince Aug 1, 2021 Accepting new patients
University Primary Care Practices Inc CurrentSince Aug 1, 2021 Accepting new patients
University Primary Care Practices Past Accepting new patients

Locations

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

1611 S Green Rd
Ste 260
South Euclid, OH 44121
Phone (216) 291-2025

Interoperability endpoints

  • Direct secure messaging: dmadhuramthakam35857@ehrdirect.uhhospitals.org

Organizations & group practices 4

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 7

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": "1521763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1073017943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1058 RIVERVIEW DR",
            "city": "MACEDONIA",
            "state": "OH",
            "postal_code": "440561622",
            "telephone_number": "330-957-1742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 S GREEN RD",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441214129",
            "telephone_number": "216-237-5011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "327 Beach 19th St",
            "address_purpose": "LOCATION",
            "city": "Far Rockaway",
            "state": "NY",
            "postal_code": "116914423",
            "country_code": "US",
            "telephone_number": "718-869-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MADHURAMTHAKAM",
        "first_name": "DIVYA SREE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-23",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.142344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Euclid, OH

Sources for this page

Verify at the official NPI Registry.