Individual provider Active NPI

Sachidanandan Naidu, M.D.

  • Specialist
  • Oklahoma City, OK
National Provider Identifier
1104856160
Registry record updated Feb 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
21643 Issued in OK
Practice address
1919 E Memorial Rd
Oklahoma City, OK 73131-1253
Phone
(405) 341-7009
Fax
(405) 330-1811
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 21643 OK Primary

Addresses

Primary practice location

1919 E Memorial Rd
Oklahoma City, OK 73131-1253

Mailing address

1919 E Memorial Rd
Oklahoma City, OK 73131-1253
Phone (405) 341-7009

Other identifiers 2

IdentifierTypeStateIssuer
100251100AMedicaidOK
1104856160OtherOKBLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20070531000438 OK Practitioner - Family PracticePractitioner - Emergency Medicine 9931140266 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Practice addresses (Care Compare)

1919 E Memorial Rd
Oklahoma City, OK 73131-1253
Phone (405) 341-7009

4300 McAuley Blvd
Oklahoma City, OK 73120-8302
Phone (405) 936-5455

520 S Mustang Rd
Yukon, OK 73099-6737
Phone (405) 936-5910

8325 NW Expressway
Oklahoma City, OK 73162-6006
Phone (405) 728-8000

Hospital & facility affiliations

  • Mercy Home Health Home health agency, Oklahoma City, OK, CCN 377048
  • Mercy Hospital Oklahoma City, Inc Hospital, Oklahoma City, OK, CCN 370013
  • O U Medical Center Hospital, Oklahoma City, OK, CCN 370093

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21643OKMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Plains Medical Center of Garvin County LLC CurrentSince Apr 29, 2022 Accepting new patients
Southern Plains Medical Center of Garvin County LLC CurrentSince Apr 29, 2022 Accepting new patients
Sachidanandan Naidu, MD, PLLC CurrentSince Jul 27, 2026 Accepting new patients
Mercy Clinic Oklahoma Communities CurrentSince Jan 1, 2011 Accepting new patients
Mercy Hospital Oklahoma City, Inc Past Accepting new patients
Lightstar Emergency Physicians, PLLC Past Accepting new patients
National Family Medical Associates, LLC PastSince Feb 1, 2023 Accepting new patients
Summit Medical Center Past Accepting new patients
Deaconess Physician Services LLC Past Accepting new patients
Centennial Health, PC PastSince May 1, 1992 Accepting new patients
Washita Emergency Physicians LLC Past Accepting new patients
Mercy Hospital Oklahoma City, Inc Past Accepting new patients

Locations

4300 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 752-3962

8325 NW Expressway
Oklahoma City, OK 73162
Phone (405) 728-8000

4345 W Memorial Rd
Ste 110
Oklahoma City, OK 73134
Phone (405) 749-7099

13901 McAuley Blvd
Ste 301
Oklahoma City, OK 73134
Phone (405) 205-2918

1919 E Memorial Rd
Oklahoma City, OK 73131
Phone (405) 341-7009

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

100 Valley Dr
Pauls Valley, OK 73075
Phone (405) 238-5501

Interoperability endpoints

  • Direct secure messaging: snaidu103471@directc.mercy.net

Organizations & group practices 12

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 3

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362009600000",
    "number": "1104856160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 E MEMORIAL RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731311253",
            "telephone_number": "405-341-7009",
            "fax_number": "405-330-1811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 E MEMORIAL RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731311253",
            "telephone_number": "405-341-7009",
            "fax_number": "405-330-1811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIDU",
        "first_name": "SACHIDANANDAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2013-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OK",
            "license": "21643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100251100A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "1104856160",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.