Sri Medical Center, Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SRI MEDICAL CENTER, INC

Practice address

2115 Millburn Ave
Maplewood, NJ 07040-3724

Phone

(973) 275-0570

Fax

(973) 900-8453

NPI assigned

Oct 19, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Shailender Karry Mohanrao, M.D.NPI 1093745077

Title

M.D.

Phone

(732) 829-8476

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shailender Karry Mohanrao, MD

  • Internal Medicine Physician
  • Maplewood, NJ
  • NPI 1093745077
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1539907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559692800000",
    "number": "1124594809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4577",
            "city": "METUCHEN",
            "state": "NJ",
            "postal_code": "088404577",
            "telephone_number": "973-275-0570",
            "fax_number": "973-900-8453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 MILLBURN AVE",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403724",
            "telephone_number": "973-275-0570",
            "fax_number": "973-900-8453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRI MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-19",
        "last_updated": "2019-06-05",
        "status": "A",
        "authorized_official_last_name": "KARRY MOHANRAO",
        "authorized_official_first_name": "SHAILENDER",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "732-829-8476",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0155641",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael J Soya, PT, DPT
• Jenna Spak
• Adanika Lashawn Speid, BT
• Stacey L. Spencer, ED.D
• Leslie Anne Springer, LCSW
• Ratnesh Kumar Srivastava, OTR
• Anetude St Jean
• Fernande St Jean
• Norman J Stack, VMD
• Standard Residential Care LLC

• Internal Medicine Physician in Maplewood, NJ
• Providers in Maplewood, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.