Sreekar Maruvada, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

N3871 Issued in TX

Practice address

210 Lake Rd Ste 800B
Lake Jackson, TX 77566

Phone

(979) 299-6400

Fax

(979) 299-6401

NPI assigned

May 7, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Pediatric Medicine

Education

Other, 2003

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: smaruvada457517@direct.stlukeshealth.org

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.

• Stephen F. Austin Community Health Center, Inc.

  dba Adoue Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Alvin, TX
  • NPI 1578730818
  Medicare reassignment
• Kids Way Clinic

  • Primary Care Clinic/Center
  • Lake Jackson, TX
  • NPI 1932330917
  NPD (past) Authorized official

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

{
    "created_epoch": "1241654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1144454026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 LAKE RD STE 800B",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "77566",
            "telephone_number": "979-299-6400",
            "fax_number": "979-299-6401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 LAKE RD STE 800B",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "77566",
            "telephone_number": "979-299-6400",
            "fax_number": "979-299-6401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5530 Long Prairie Trce",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "TX",
            "postal_code": "774072329",
            "country_code": "US",
            "telephone_number": "832-400-9623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARUVADA",
        "first_name": "SREEKAR",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-07",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "N3871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203105601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THSTEPS",
            "identifier": "203105602",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Nicole Marley-McCann, CCC-SLP
• Blaine Marshall
• Jana K Marshall, MD
• Henry Enoc Martinez, M.D.
• Richard Martinez, DC
• Robert Paul Massey II, DC
• Kaitlyn Adelle Matejowsky
• Clinton Matkins, DDS
• Christi M Matteck, RDH
• Maureen J Meehl Bipolar/BPD Founation (The Meehl Foundation)

• Pediatrics Physician in Lake Jackson, TX
• Providers in Lake Jackson, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; 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.