Srisatish Devapatla, M.D., FAAP

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

001544 Issued in NY

Practice address

101 Dates Dr
Ithaca, NY 14850-1342

Phone

(607) 274-4496

Fax

(607) 274-4232

NPI assigned

Jan 29, 2007

Sex

Male

Sole proprietor

No

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 NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• NHCS Physicians Inc

  • Cardiovascular Disease Physician
  • Rocky Mount, NC
  • NPI 1801252275

  NC, Neonatal-Perinatal Medicine

  Medicare reassignment NPD
• Cayuga Medical Center at Ithaca

  • General Acute Care Hospital
  • Ithaca, NY
  • NPI 1962422733
  NPD (past)

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1164568176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 CAYUGA HEIGHTS RD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501423",
            "telephone_number": "607-319-4320",
            "fax_number": "607-274-4232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DATES DR",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501342",
            "telephone_number": "607-274-4496",
            "fax_number": "607-274-4232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVAPATLA",
        "first_name": "SRISATISH",
        "name_prefix": "Dr.",
        "credential": "M.D., FAAP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NY",
            "license": "001544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001544",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06000001544",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dermatology Associates of Ithaca, LLC
• Adam Derue, RPH
• Ravi Desai, BS PHARMACY
• Allison Desario
• Audrey H Desilva, MD
• Chris Devenpeck, DDS
• Bradley Thomas Dewitt, PA-C
• Diane J Reppert Chiropractor PLLC
• Debra Jean Dibartolo, FNP
• Laura Susan Dibble, M.D.

• All providers in Ithaca, NY
• Neonatal-Perinatal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.