Poojitha Reddy Beravol, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

MD171595 Issued in OR

Practice address

3615 NW Samaritan Dr
Suite 203
Corvallis, OR 97330-3783

Phone

(541) 768-6930

NPI assigned

Jun 1, 2009

Last updated

Mar 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA, MT, WI, NM, AR, FL, OH, AL, VA9 enrollments

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 9

Specialty

Internal Medicine

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Access Telecare PLLCGroup PAC ID 7810204831, 409 clinicians

Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Central Washington Health Services AssociationGroup PAC ID 4880504596, 708 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Confluence Health Hospital Hospital, Wenatchee, WA, CCN 500016
• St Anthony Hospital Hospital, Gig Harbor, WA, CCN 500151
• St Francis Community Hospital Hospital, Federal Way, WA, CCN 500141
• St Clare Hospital Hospital, Lakewood, WA, CCN 500021
• St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pberavol212703@achce.catholichealth.net
• Direct secure messaging: pberavol235062@samhealth.direct-ci.com
• Direct secure messaging: pberavol630603@direct.emplifyhealth.org
• Direct secure messaging: pberavol98274@edirect.chehr.org

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.

• Access Telecare, PLLC

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1013303080

  AL, AR, FL, MT, NM, OH, VA, WA

  Medicare reassignment Care Compare group NPD
• Central Washington Health Services Association

  dba Confluence Health

  • Emergency Medical Services (Emergency Medicine) Physician
  • Wenatchee, WA
  • NPI 1801937453
  Medicare reassignment Care Compare group NPD
• Franciscan Medical Group

  dba Franciscan Orthopedics-Silverdale

  • Orthopaedic Surgery Physician
  • Silverdale, WA
  • NPI 1093165334
  Medicare reassignment Care Compare group NPD
• Gundersen Lutheran Medical Center Inc

  dba Emplify Health Hamilton Clinic

  • Clinic/Center
  • La Crosse, WI
  • NPI 1225873458
  Medicare reassignment NPD
• Valley Medical Group-Renton

  • General Acute Care Hospital
  • Renton, WA
  • NPI 1619209574
  Medicare reassignment NPD
• Central Washington Health Services Association

  dba Confluence Health

  • General Acute Care Hospital
  • Wenatchee, WA
  • NPI 1881642239
  NPD
• East Alabama Medical Center Pec

  • General Acute Care Hospital
  • Opelika, AL
  • NPI 1811438054
  NPD
• Franciscan Medical Group

  • Family Medicine Physician
  • Tacoma, WA
  • NPI 1366539421
  NPD
• Gundersen Lutheran Medical Center, Inc

  dba Emplify Health La Crosse Clinic

  • Clinic/Center
  • La Crosse, WI
  • NPI 1689918377

  Nephrology

  NPD
• Gundersen Lutheran Medical Center, Inc

  dba Emplify Health Onalaska Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Onalaska, WI
  • NPI 1871837567
  NPD
• Ozark Tri-County Health Care Consortium

  dba Access Family Care

  • Federally Qualified Health Center (FQHC)
  • Joplin, MO
  • NPI 1538151733
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Central Washington Health Services Association

  dba Confluence Health

  • General Acute Care Hospital
  • Wenatchee, WA
  • NPI 1306883228
  Care Compare affiliation
• Commonspirit Washington

  dba St Joseph Lab PAC LAB

  • Clinical Medical Laboratory
  • Tacoma, WA
  • NPI 1659585370

  Hospital

  Care Compare affiliation
• Commonspirit Washington

  dba St Joseph Medical Center

  • General Acute Care Hospital
  • Tacoma, WA
  • NPI 1952309098
  Care Compare affiliation
• Franciscan Health System

  dba St Joseph Medical Center

  • General Acute Care Hospital
  • Tacoma, WA
  • NPI 1124291117
  Care Compare affiliation
• Franciscan Health System

  dba St Anthony Hospital

  • General Acute Care Hospital
  • Gig Harbor, WA
  • NPI 1447406699
  Care Compare affiliation
• Saint Clare Hospital

  dba Paclab

  • Clinical Medical Laboratory
  • Lakewood, WA
  • NPI 1003029745

  Hospital

  Care Compare affiliation
• Saint Clare Hospital

  dba ST. Clare Hospital

  • General Acute Care Hospital
  • Lakewood, WA
  • NPI 1689672693
  Care Compare affiliation
• St Francis Community Hospital

  • General Acute Care Hospital
  • Federal Way, WA
  • NPI 1093713091
  Care Compare affiliation
• St Francis Community Hospital

  dba St Francis Pac Lab

  • Clinical Medical Laboratory
  • Federal Way, WA
  • NPI 1336353069

  Hospital

  Care Compare affiliation
• St Francis Community Hospital

  • General Acute Care Hospital
  • Federal Way, WA
  • NPI 1922305606
  Care Compare affiliation

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

{
    "created_epoch": "1243814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1073749396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3615 NW SAMARITAN DR",
            "address_2": "SUITE 203",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303783",
            "telephone_number": "541-768-6930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1836 South Ave",
            "address_purpose": "LOCATION",
            "city": "LA Crosse",
            "state": "WI",
            "postal_code": "546015429",
            "country_code": "US",
            "telephone_number": "608-782-7300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERAVOL",
        "first_name": "POOJITHA",
        "middle_name": "REDDY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-01",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WI",
            "license": "1343",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WA",
            "license": "MD60697665",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OR",
            "license": "MD171595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pberavol235062@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "3615 NW Samaritan Dr",
            "address_2": "Suite 203",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973303783",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Autumn Benton, M.ED
• Marcus J Benton, B.ED, CADC I
• Nick C Benton, M.D.
• Lynn A. Bentson, M.D, MACP
• Amer Benyounes
• Kathrine Ashley Berg
• Meraina C Berge, LPN
• Kyle Bergmann, RD
• Seth Philip Berkowitz, DO
• Leslie B Berman, DC

• Nephrology Physician in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Nephrology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.