Individual provider Active NPI

Srinivas Rajamahanty, M.D.

  • Urology Physician
  • Carbondale, IL
National Provider Identifier
1124339403
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
036127544 Issued in IL
Practice address
305 W Jackson St Ste 301
Carbondale, IL 62901-1474
Phone
(618) 351-9300
Fax
(618) 351-9307
NPI assigned
Jul 1, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 036127544 IL Primary

Addresses

Primary practice location

305 W Jackson St Ste 301
Carbondale, IL 62901-1474

Mailing address

PO Box 3988
Carbondale, IL 62902-3988
Phone (618) 457-5200

Other practice location 1

2601 W Main St
Carbondale, IL 62901-1031
Phone (618) 351-7300

Other practice location 2

900 N Washington St
Du Quoin, IL 62832-1233
Phone (618) 351-9300

Other identifiers 2

IdentifierTypeStateIssuer
036127544MedicaidIL
5915178MedicaidNC

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address srajamahanty13645@sih.direct-ci.com
Direct Messaging Address srajamahanty13645@sih.direct-ci.com
Direct Messaging Address srajamahanty13645@sih.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20110824000509 IL Practitioner - Urology 2365575057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Illinois Medical Services NFPGroup PAC ID 3678677390, 331 clinicians

Practice addresses (Care Compare)

2 S Hospital Dr
Murphysboro, IL 62966-3333
Phone (618) 684-3156

220 S Park Ave
Herrin, IL 62948-3602

2601 W Main St
Carbondale, IL 62901-1031
Phone (618) 549-5361

305 W Jackson St
Carbondale, IL 62901-1474

405 W Jackson St
Carbondale, IL 62901-1462
Phone (618) 549-0721

Hospital & facility affiliations

  • Memorial Hospital of Carbondale Hospital, Carbondale, IL, CCN 140164
  • Herrin Hospital Hospital, Herrin, IL, CCN 140011
  • St Joseph Memorial Hospital Hospital, Murphysboro, IL, CCN 141334
  • Marshall Browning Hospital Hospital, Du Quoin, IL, CCN 141331
  • Harrisburg Medical Center Hospital, Harrisburg, IL, CCN 140210

Merit-based Incentive Payment System (MIPS)

Final score
82 of 100Reported as group
Quality
55.9
Promoting interoperability
100
Improvement activities
40
Cost
72.01

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection15
Removal of tissue1-10
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Illinois Medical Services, NFP CurrentSince Jul 29, 2011 Accepting new patients
Southern Illinois Gi Specialists LLC PastSince Nov 1, 2020 Accepting new patients

Locations

305 W Jackson St
Ste 300
Carbondale, IL 62901
Phone (618) 457-3006

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

305 W Jackson St
Ste 303
Carbondale, IL 62901
Phone (618) 351-4976

305 W Jackson St
Ste 301
Carbondale, IL 62901
Phone (618) 529-0520

900 N Washington St
Du Quoin, IL 62832
Phone (618) 542-1050

Interoperability endpoints

  • FHIR API: https://fa120b5c-6699-49eb-9b43-fa51a183b3cb.gastro.prod.fhir.ema-api.com/fhir/r4/

Organizations & group practices 2

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 5

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": "1277942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1124339403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3988",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629023988",
            "telephone_number": "618-457-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W JACKSON ST STE 301",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011474",
            "telephone_number": "618-351-9300",
            "fax_number": "618-351-9307"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2601 W Main St",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629011031",
            "country_code": "US",
            "telephone_number": "618-351-7300",
            "fax_number": "618-457-7890",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 N Washington St",
            "address_purpose": "LOCATION",
            "city": "Du Quoin",
            "state": "IL",
            "postal_code": "628321233",
            "country_code": "US",
            "telephone_number": "618-351-9300",
            "fax_number": "618-351-6543",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAJAMAHANTY",
        "first_name": "SRINIVAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-01",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "036127544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036127544",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5915178",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "srajamahanty13645@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "2601 W Main St",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011031",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "srajamahanty13645@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "900 N Washington St",
            "city": "Du Quoin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "628321233",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "srajamahanty13645@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "305 W Jackson St Ste 301",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.