Srinivasa Reddy Vaka, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

65117 Issued in MN

Practice address

Fairview Clinics-Bass Lake
6320 Wedgwood Rd N
Maple Grove, MN 55311-3647

Phone

(763) 268-0400

Fax

(763) 268-0405

NPI assigned

Feb 17, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Internal Medicine

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Accentcare Fairview Home Health - West, LLC Home health agency, Saint Paul, MN, CCN 247078
• M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080
• M Health Fairview Southdale Hospital Hospital, Edina, MN, CCN 240078

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: svaka492435@fairview.direct-ci.com

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.

• Fairview Clinics

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1346432218

  MN

  Medicare reassignment Care Compare group NPD
• Fairview Bethesda Hospital

  • Long Term Care Hospital
  • Saint Paul, MN
  • NPI 1194787465

  MN

  Medicare reassignment NPD
• Fairview Express Care

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606

  MN

  Medicare reassignment NPD
• Healtheast Medical Research Institute

  • Clinic/Center
  • Vadnais Heights, MN
  • NPI 1639125503

  MN

  Medicare reassignment NPD
• Healtheast St. John'S Hospital

  • General Acute Care Hospital
  • Maplewood, MN
  • NPI 1447218482

  MN

  Medicare reassignment NPD
• Healtheast Woodwinds Hospital

  • General Acute Care Hospital
  • Woodbury, MN
  • NPI 1356309322

  MN

  Medicare reassignment NPD
• Fairview Health Services

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1811077175

  MN

  Medicare reassignment
• Fairview Clinics

  • Specialist
  • River Falls, WI
  • NPI 1811550155
  Care Compare group
• Fairview Clinics

  • Primary Care Clinic/Center
  • Saint Paul, MN
  • NPI 1396552147
  NPD
• Fairview Clinics

  • Primary Care Clinic/Center
  • Lakeville, MN
  • NPI 1851583637
  NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD
• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  NPD

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

• Accentcare Fairview Home Health - West, LLC

  • Home Health Agency
  • Saint Paul, MN
  • NPI 1477169233
  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359

  Hospital

  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1316008212

  Hospital

  Care Compare affiliation
• Fairview Health Services

  • Skilled Nursing Facility
  • Minneapolis, MN
  • NPI 1669459913

  Hospital

  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Edina, MN
  • NPI 1699752915

  Hospital

  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Edina, MN
  • NPI 1932260833

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1234828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1184863938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FAIRVIEW CLINICS-BASS LAKE",
            "address_2": "6320 WEDGWOOD RD N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553113647",
            "telephone_number": "763-268-0400",
            "fax_number": "763-268-0405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FAIRVIEW CLINICS-BASS LAKE",
            "address_2": "6320 WEDGWOOD RD N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553113647",
            "telephone_number": "763-268-0400",
            "fax_number": "763-268-0405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Park Dr",
            "address_purpose": "LOCATION",
            "city": "Benton",
            "state": "AR",
            "postal_code": "720153353",
            "country_code": "US",
            "telephone_number": "501-776-6093",
            "fax_number": "501-776-6019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAKA",
        "first_name": "SRINIVASA",
        "middle_name": "REDDY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-17",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E7137",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AR",
            "license": "E7137",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "65117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Maple Grove, MN
• Internal Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; 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.