Individual provider Active NPI

Sreedevi Chennupati, M.D.

  • Nephrology Physician
  • Rochester, NY
National Provider Identifier
1164559530
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
233042 Issued in NY
Practice address
1425 Portland Ave
Rochester, NY 14621-3001
Phone
(585) 922-0400
Fax
(585) 922-0455
NPI assigned
Feb 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 233042 NY Primary

Addresses

Primary practice location

1425 Portland Ave
Rochester, NY 14621-3001

Mailing address

1425 Portland Ave
Box 242
Rochester, NY 14621-3001
Phone (585) 922-0400

Other identifiers 2

IdentifierTypeStateIssuer
02590238MedicaidNY
01131126/RGHMedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address schennupati52152@direct.rochesterregional.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040907000795 NY Practitioner - NephrologyPractitioner - Internal Medicine 3173599701 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rochester General HospitalGroup PAC ID 0244149474, 1,192 clinicians
Western New York Medical Practice PCGroup PAC ID 3870767791, 528 clinicians

Practice addresses (Care Compare)

1425 Portland Ave
Rochester, NY 14621-3001
Phone (585) 922-4000

1425 Portland Ave
Rochester, NY 14621-3011
Phone (585) 922-4000

370 E Ridge Rd
Rochester, NY 14621-1240
Phone (585) 922-0600

Hospital & facility affiliations

  • Rochester General Hospital - Bay Creek Dialysis Center Dialysis facility, Webster, NY, CCN 333569
  • Rochester General Hospital Dialysis Center Dialysis facility, Rochester, NY, CCN 333554
  • Rochester General Hospital Hospital, Rochester, NY, CCN 330125

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital Current Accepting new patients
Western New York Medical Practice P.C. CurrentSince Apr 1, 2014 Accepting new patients
Rochester General Hospital CurrentSince Sep 14, 2011 Accepting new patients
Newark Wayne Community Hospital CurrentSince Sep 14, 2011 Accepting new patients
Rochester General Hospital CurrentSince Sep 14, 2011 Accepting new patients
Newark Wayne Community Hospital Current Accepting new patients
Rochester General Hospital Past Accepting new patients
Department of Medicine Faculty Practice Nephrology Past Accepting new patients

Locations

1200 Driving Park Ave
Newark, NY 14513
Phone (315) 332-2266

370 E Ridge Rd
Ste 20
Rochester, NY 14621
Phone (585) 922-0400

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1425 Portland Ave
#242
Rochester, NY 14621
Phone (585) 922-3662

Interoperability endpoints

  • Direct secure messaging: schennupati52152@direct.rochesterregional.org

Organizations & group practices 8

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": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1164559530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 PORTLAND AVE",
            "address_2": "BOX 242",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213001",
            "telephone_number": "585-922-0400",
            "fax_number": "585-922-0455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 PORTLAND AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213001",
            "telephone_number": "585-922-0400",
            "fax_number": "585-922-0455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENNUPATI",
        "first_name": "SREEDEVI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "233042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02590238",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01131126/RGH",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "schennupati52152@direct.rochesterregional.org",
            "affiliation": "N",
            "address_1": "1425 Portland Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146213001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.