Individual provider Active NPI

Vinaya Ramakrishnan Sermadevi, M.D.

  • Internal Medicine Physician
  • Kew Gardens Hills, NY
National Provider Identifier
1114243235
Registry record updated Apr 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
255502 Issued in NY
Practice address
15030 78TH Rd
Kew Gardens Hills, NY 11367-3540
Phone
(718) 374-1091
NPI assigned
Apr 14, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 255502 NY Primary

Addresses

Primary practice location

15030 78TH Rd
Kew Gardens Hills, NY 11367-3540

Mailing address

15030 78TH Rd
Kew Gardens Hills, NY 11367-3540
Phone (718) 374-1091

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20131001000543 MO Practitioner - Internal Medicine 4688703416 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Adult Critical Care LLCGroup PAC ID 3779512041, 59 clinicians

Practice addresses (Care Compare)

615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone (314) 251-6486

Hospital & facility affiliations

  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
255502NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Adult Critical Care, LLC CurrentSince Jul 13, 2013 Accepting new patients
Mercy Aco Clinical Services Inc CurrentSince Jun 17, 2020 Accepting new patients
Mercy Hospitals East Communities Internal Medicine Past Accepting new patients

Locations

15740 South Outer 40 Rd
Chesterfield, MO 63017
Phone (636) 735-4268

625 S New Ballas Rd
Ste 7020
Saint Louis, MO 63141
Phone (314) 251-6486

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

901 E 5th St
Washington, MO 63090
Phone (636) 239-8000

Organizations & group practices 3

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 2

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": "1271203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271203200000",
    "number": "1114243235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15030 78TH RD",
            "city": "KEW GARDENS HILLS",
            "state": "NY",
            "postal_code": "113673540",
            "telephone_number": "718-374-1091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15030 78TH RD",
            "city": "KEW GARDENS HILLS",
            "state": "NY",
            "postal_code": "113673540",
            "telephone_number": "718-374-1091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERMADEVI",
        "first_name": "VINAYA",
        "middle_name": "RAMAKRISHNAN",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-14",
        "last_updated": "2010-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "255502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kew Gardens Hills, NY

Sources for this page

Verify at the official NPI Registry.