Individual provider Active NPI

Anusha Yanamadala, M.D

  • Internal Medicine Physician
  • Rockford, IL
National Provider Identifier
1174978027
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036148992 Issued in IL
Practice address
8201 E Riverside Blvd
Rockford, IL 61114-2300
Phone
(708) 783-6566
Fax
(708) 783-6567
NPI assigned
Apr 28, 2016
Last updated
Jun 18, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036148992 IL Primary

Addresses

Primary practice location

8201 E Riverside Blvd
Rockford, IL 61114-2300

Mailing address

8201 E Riverside Blvd
Rockford, IL 61114-2300
Phone (201) 626-0897

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, NM2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190716001512 IL Practitioner - Internal Medicine 9537420369 Reassigns benefits to 1 organization
I20200921002009 NM Practitioner - Internal Medicine 9537420369 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Health Physicians CurrentSince Jun 24, 2019 Accepting new patients
Hospitalist Medicine Physicians of New Mexico-TCG LLC Internal Medicine CurrentSince Mar 1, 2020 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Internal Medicine CurrentSince Mar 1, 2020 Accepting new patients
Cogent Healthcare of Texas, PA Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

2300 N Rockton Ave
Rockford, IL 61103

2400 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-6310

8201 E Riverside Blvd
Rockford, IL 61114
Phone (815) 971-4066

2100 N Mlk Blvd
Clovis, NM 88101
Phone (505) 769-2141

2400 Unser Blvd SE
Rio Rancho, NM 87124
Phone (505) 253-0000

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-5600

Interoperability endpoints

  • Direct secure messaging: ayanamadala64083@direct.mhemail.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1461801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1174978027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8201 E RIVERSIDE BLVD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611142300",
            "telephone_number": "201-626-0897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8201 E RIVERSIDE BLVD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611142300",
            "telephone_number": "708-783-6566",
            "fax_number": "708-783-6567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANAMADALA",
        "first_name": "ANUSHA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-28",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036148992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.