Sarat Yalamanchili, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036-094568 Issued in IL

Practice address

1521 N Convent St Ste 101
Bourbonnais, IL 60914-1469

Phone

(815) 937-4500

Fax

(815) 937-4777

NPI assigned

Jul 7, 2005

Reactivated

Mar 28, 2006

Last updated

Mar 16, 2021By 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 1

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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

• Healthtap Medical Group, P.C.

  • General Practice Physician
  • Portola Valley, CA
  • NPI 1518330539

  IL

  Medicare reassignment NPD
• Illinois Laser & Vein Center, LLC

  • Medical Specialty Clinic/Center
  • Bourbonnais, IL
  • NPI 1699847848
  Authorized official Same address or phone
• Sarat Yalamanchili, MD, SC

  • Internal Medicine Physician
  • Bourbonnais, IL
  • NPI 1245245026
  Authorized official Same address or phone
• Gibson Community Hospital Association

  dba Gibson Area Hospital and Health Services

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1194722942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 N CONVENT ST STE 101",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141469",
            "telephone_number": "815-937-4500",
            "fax_number": "815-937-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 N CONVENT ST STE 101",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141469",
            "telephone_number": "815-937-4500",
            "fax_number": "815-937-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YALAMANCHILI",
        "first_name": "SARAT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2006-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-094568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4632101",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00763066",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036094568",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lasercare@direct.practicefusion.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1521 N Convent St Ste 101",
            "city": "Bourbonnais",
            "state": "IL",
            "country_code": "US",
            "postal_code": "609141469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer Lane Worden, PT
• Stephanie Claire Worman
• Lynn Wotell, RPH
• Jennifer Wright, FNP-BC
• Ming Xu, MD
• Saroja Yalamanchili, MD
• Sara Elizabeth Tan Yap, MD
• Yictory Health Inc
• Kate E Young, SLP
• Sara Sameiha Youssef

• Internal Medicine Physician in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; 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.