Srinivasachari Tatadesika Chakravarthi, MD

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

35085008 Issued in OH

Practice address

2222 Cherry St
Suite M200
Toledo, OH 43608-2673

Phone

(419) 251-8019

Fax

(419) 251-5819

NPI assigned

Mar 1, 2006

Last updated

Sep 17, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 14

Medicare fee-for-service enrollment

Enrolled in MI

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

Neurosurgery

Education

Other, 1972

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• McLaren Bay Region Hospital, Bay City, MI, CCN 230041

Procedures performed for Medicare patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brain and Spine Associates PC

  • Neurological Surgery Physician
  • Bay City, MI
  • NPI 1710651195
  Medicare reassignment NPD Authorized official
• Bay Area Health Clinic PC

  • Internal Medicine Physician
  • Bay City, MI
  • NPI 1013923770
  Medicare reassignment NPD
• McLaren Bay Region

  • General Acute Care Hospital
  • Bay City, MI
  • NPI 1528031226
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• McLaren Bay Region

  • General Acute Care Hospital
  • Bay City, MI
  • NPI 1528031226
  Care Compare affiliation

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442448000000",
    "number": "1174590962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 JEFFERSON AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436047101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 CHERRY ST",
            "address_2": "SUITE M200",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436082673",
            "telephone_number": "419-251-8019",
            "fax_number": "419-251-5819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAKRAVARTHI",
        "first_name": "SRINIVASACHARI",
        "middle_name": "TATADESIKA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2015-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MI",
            "license": "4301084746",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "OH",
            "license": "35085008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4685161",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0132377",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BAY HEALTH PLAN",
            "identifier": "0999980",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "1400910402",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4753593",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4753637",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "700Z946010",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN HEALTH PLAN",
            "identifier": "1013097",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ADVANTAGE NETWORK",
            "identifier": "1013097",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY BLUE PPO",
            "identifier": "700Z946010",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "700Z946010",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLUS",
            "identifier": "0999980",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "700Z946010",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7344665",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leon Victor Chagolla II, CRNA
• Bhupinder Singh Chahal, M.D.
• Nivene Chahine, PA-C
• Annapoorna Chakrabarty, MD
• Shudipan Chakraborty
• Jyoti Chakravarty, M.D.
• Supriya Chakravarty, MD
• Christopher Challenger
• Kaisa Chalmers
• Cale Chaltron

• Neurological Surgery Physician in Toledo, OH
• Providers in Toledo, OH by specialty
• Neurological Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2015; 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.