Individual provider Active NPI

Srinidhi Reddy Pulusani, MD

  • Dermatology Physician
  • Memphis, TN
National Provider Identifier
1215490644
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
68190 Issued in TN
Practice address
930 Madison Ave Ste 801
Memphis, TN 38103-3410
Phone
(901) 866-8805
Fax
(901) 302-2790
NPI assigned
Apr 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 68190 TN Primary

Addresses

Primary practice location

930 Madison Ave Ste 801
Memphis, TN 38103-3410

Mailing address

1068 Cresthaven Rd Ste 300
Memphis, TN 38119-0809

Other practice location 1

University Of Tennessee 930 Madison Avenue Suite 840
Memphis, TN 38163-0001
Phone (901) 448-5769

Other practice location 2

1068 Cresthaven Rd Ste 210
Memphis, TN 38119-0845
Phone (901) 866-8805

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20230804000486 TN Practitioner - Dermatology 9739540949 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Tennessee, HSC, College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut Medical Group IncGroup PAC ID 3173435369, 98 clinicians

Practice addresses (Care Compare)

930 Madison Ave
Suite 801
Memphis, TN 38103-3410
Phone (901) 866-8790

Hospital & facility affiliations

  • Regional One Health Hospital, Memphis, TN, CCN 440152

Merit-based Incentive Payment System (MIPS)

Final score
88.15 of 100Reported as group
Quality
59.97
Promoting interoperability
100
Improvement activities
40
Cost
80.93

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Skin biopsy21

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Medical Group, Inc. CurrentSince Jul 1, 2023 Accepting new patients
Ut Medical Group Inc Dermatology CurrentSince Jul 1, 2023 Accepting new patients

Locations

930 Madison Ave
Ste 200
Memphis, TN 38103
Phone (901) 448-6650

1068 Cresthaven Rd
Ste 210
Memphis, TN 38119
Phone (901) 866-8805

930 Madison Ave
Ste 801
Memphis, TN 38103
Phone (901) 866-8605

1068 Cresthaven Rd
Ste 300
Memphis, TN 38119
Phone (901) 683-0024

Interoperability endpoints

  • Direct secure messaging: spulusani33358@mlh.direct-ci.com
  • Direct secure messaging: spulusani546469@direct.bmhcc.org

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1554940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1215490644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1068 CRESTHAVEN RD STE 300",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381190809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 MADISON AVE STE 801",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381033410",
            "telephone_number": "901-866-8805",
            "fax_number": "901-302-2790"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "University Of Tennessee 930 Madison Avenue Suite 840",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381630001",
            "country_code": "US",
            "telephone_number": "901-448-5769",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1068 Cresthaven Rd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381190845",
            "country_code": "US",
            "telephone_number": "901-866-8805",
            "fax_number": "901-302-2790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PULUSANI",
        "first_name": "SRINIDHI",
        "middle_name": "REDDY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-11",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TN",
            "license": "68190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.