Active NPI
Sivacharan Buddhavarapu, M.D.
- Cardiovascular Disease Physician
- Peoria, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 036.163965
- Practice address
- 112 NE Crescent Ave
Peoria, IL 61606-1901 - Phone
- (309) 672-4670
- NPI assigned
- Jun 28, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 036.163965 | IL | Primary |
Addresses
Primary practice location
112 NE Crescent Ave
Peoria, IL 61606-1901
Mailing address
112 NE Crescent Ave
Peoria, IL 61606-1901
Phone (309) 672-4670
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
112 NE Crescent Ave
Peoria, IL 61606-1901
Phone (309) 672-4670
1302 N Greenwood St
Spring Valley, IL 61362-1576
Phone (779) 323-8150
1909 N Morton Ave
Morton, IL 61550-1426
Phone (309) 263-4343
2076 N Main St
Canton, IL 61520-1054
Phone (309) 674-6090
221 NE Glen Oak Ave
Peoria, IL 61636-0001
2338 W Van Winkle Way
Suite 1100
Peoria, IL 61615-7401
Phone (309) 672-4670
3591 Griffin Ave
Pekin, IL 61554-6258
5401 N Knoxville Ave
Peoria, IL 61614-5021
5409 N Knoxville Ave
Peoria, IL 61614-5069
Phone (309) 691-1000
600 S 13TH St
Pekin, IL 61554-4936
611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753
8914 N Knoxville Ave
Peoria, IL 61615-1410
Phone (309) 691-9110
900 Main St
Peoria, IL 61602-1060
Hospital & facility affiliations
- Carle Health Methodist Hospital
- Carle Health Proctor Hospital
- Carle Health Pekin Hospital
- Saint Francis Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Pacemaker insertion or repair | 46 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.163965 | IL | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Proctor Health Systems | Current | Accepting new patients | |
| Methodist Medical Center of Illinois | Current | Accepting new patients | |
| Proctor Health Systems | Current | Accepting new patients | |
| Carle Health Care Incorporated | Cardiovascular Disease | Current | Accepting new patients |
| Methodist Medical Center of Illinois | Current | Accepting new patients |
Locations
1506 W Garfield Ave
Bartonville, IL 61607
Phone (309) 697-2416
815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986
221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281
815 Main St
Ste A1
Peoria, IL 61602
5401 N Knoxville Ave
Ste 400
Peoria, IL 61614
Phone (309) 691-6610
112 NE Crescent Ave
Peoria, IL 61606
Phone (309) 680-2402
120 NE Glen Oak Ave
Peoria, IL 61603
Phone (309) 672-3158
611 W Park St
Urbana, IL 61801
Phone (217) 383-6941
Interoperability endpoints
- sbuddhavarapu8866@prd.direct.tbh.org
- sbuddhavarapumd388484@carlehiedirect.net
Organizations & group practices 5
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.
-
dba Carle Physician Group
- Internal Medicine Physician
- Urbana, IL
- NPI 1154653947
Cardiovascular Disease
-
- Rehabilitation Hospital Unit
- Peoria, IL
- NPI 1982656575
-
- Family Medicine Physician
- Peoria, IL
- NPI 1134173917
-
- General Acute Care Hospital
- Peoria, IL
- NPI 1164474755
-
dba Carle Health Princeville
- Rural Health Clinic/Center
- Princeville, IL
- NPI 1356057301
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Peoria, IL
- NPI 1164474755
-
dba Proctor Hospital
- General Acute Care Hospital
- Peoria, IL
- NPI 1033116876
-
- Rehabilitation Hospital Unit
- Peoria, IL
- NPI 1134826894
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694131200000",
"number": "1245612092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "112 NE CRESCENT AVE",
"city": "PEORIA",
"state": "IL",
"postal_code": "616061901",
"telephone_number": "309-672-4670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 NE CRESCENT AVE",
"city": "PEORIA",
"state": "IL",
"postal_code": "616061901",
"telephone_number": "309-672-4670"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUDDHAVARAPU",
"first_name": "SIVACHARAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-28",
"last_updated": "2023-09-08",
"certification_date": "2023-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "IL",
"license": "036.163965",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; 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.