Sreeya Sai Komaravolu, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

LP04859 Issued in RI

Practice address

593 Eddy St
Providence, RI 02903-4923

Phone

(401) 444-5795

Fax

(401) 444-6947

NPI assigned

May 13, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in RI

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: skomaravolu@direct.carene.org

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.

• Affinity Physicians LLC.

  • Internal Medicine Physician
  • Warwick, RI
  • NPI 1184944662
  NPD

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

{
    "created_epoch": "1589328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589328000000",
    "number": "1225650286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-5795",
            "fax_number": "401-444-6947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-5795",
            "fax_number": "401-444-6947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMARAVOLU",
        "first_name": "SREEYA",
        "middle_name": "SAI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-13",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "RI",
            "license": "LP04859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Irene Kolberg, N.P.
• Martha Brown Kole-White, MD
• Kristin Kolesar Fabris, D.C.
• Meghana Koleti, MD
• Michele Kolodziejczak, RN
• Mallikarjun Reddy Komsani, MD, MBBS
• Susannah Kondrath, PHD
• Robert James Koness, M.D.
• David Ira Konicov, DDS
• Rosemary C Kopec, CRNA

• Urology Physician in Providence, RI
• Providers in Providence, RI by specialty
• Urology Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; 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.