Individual provider Active NPI

Sakuntla Kondragunta, M.D.

  • Hospitalist Physician
  • Petersburg, VA
National Provider Identifier
1184695843
Registry record updated Jul 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
0101222345 Issued in VA
Practice address
200 Medical Park Blvd
Petersburg, VA 23805-9274
Phone
(804) 765-5991
Fax
(804) 765-5809
NPI assigned
Jan 31, 2006
Last updated
Jul 31, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101222345 VA
Hospitalist Physician 208M00000X 0101222345 VA Primary

Addresses

Primary practice location

200 Medical Park Blvd
Petersburg, VA 23805-9274

Mailing address

200 Medical Park Blvd
Petersburg, VA 23805-9274
Phone (804) 765-5991

Other identifiers 3

IdentifierTypeStateIssuer
010107318MedicaidVA
1184695843OtherVAANTHEM BCBS
1184695843MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20040211000938 VA Practitioner - Internal Medicine 7517851439 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2 Bernadine Dr
Newport News, VA 23602-4404
Phone (240) 686-2300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.6 of 100Reported as group
Quality
76.36
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101222345VAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates, P.a.,P.C. Internal Medicine CurrentSince Mar 27, 2019 Accepting new patients
Emergency Medicine Associates P.a., P.C. Internal Medicine CurrentSince Mar 27, 2019 Accepting new patients
Southeastern Intensivist Services PC Internal Medicine CurrentSince Oct 20, 2019 Accepting new patients
Sakuntla PLLC Past Accepting new patients
S.B.Kondragunta LLC PastSince Jul 1, 2005 Accepting new patients
Petersburg Home Care Services LLC Past Accepting new patients
Arnot Medical Services PLLC Internal Medicine Past Accepting new patients
Southside Physician Network LLC Internal Medicine Past Accepting new patients

Locations

727 N Main St
Emporia, VA 23847
Phone (434) 348-4400

100 Fairview Dr
Franklin, VA 23851
Phone (757) 516-1153

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

8700 Sudley Rd
Manassas, VA 20110
Phone (703) 369-8000

2 Bernardine Dr
Newport News, VA 23602
Phone (757) 886-6000

1401 Johnston Willis Dr
North Chesterfield, VA 23235
Phone (804) 327-4046

200 Medical Park Blvd
Petersburg, VA 23805
Phone (804) 765-5000

7101 Jahnke Rd
Richmond, VA 23225
Phone (804) 323-1088

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/679/brand/1/csg/319/fhir/r4

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

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": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248998400000",
    "number": "1184695843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PARK BLVD",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059274",
            "telephone_number": "804-765-5991",
            "fax_number": "804-765-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PARK BLVD",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059274",
            "telephone_number": "804-765-5991",
            "fax_number": "804-765-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONDRAGUNTA",
        "first_name": "SAKUNTLA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-31",
        "last_updated": "2009-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101222345",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0101222345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010107318",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "1184695843",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184695843",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, VA

Sources for this page

Verify at the official NPI Registry.