Individual provider Active NPI

Sreekar Raghuram Vennelaganti, MD

  • Hospitalist Physician
  • Overland Park, KS
National Provider Identifier
1265728851
Registry record updated Jan 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
04-37305 Issued in KS
Practice address
12300 Metcalf Ave
Overland Park, KS 66213-1324
Phone
(816) 932-0340
Fax
(816) 932-3148
NPI assigned
Jun 22, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0437305 KS
Hospitalist Physician 208M00000X 04-37305 KS Primary

Addresses

Primary practice location

12300 Metcalf Ave
Overland Park, KS 66213-1324

Mailing address

901 E 104TH St
Kansas City, MO 64131-4517
Phone (816) 502-8752

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170831002061 FL Practitioner - Hospitalist 9739300773 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tallahassee Memorial Healthcare IncGroup PAC ID 6103724778, 498 clinicians

Practice addresses (Care Compare)

1300 Miccosukee Rd
Tallahassee, FL 32308-5054
Phone (850) 431-6200

Hospital & facility affiliations

  • Tallahassee Memorial Healthcare Hospital, Tallahassee, FL, CCN 100135

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-37305KSMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahassee Memorial Healthcare Inc Current Accepting new patients
Tallahassee Memorial Healthcare Inc Internal Medicine CurrentSince Aug 8, 2017 Accepting new patients
Tallahassee Memorial Healthcare Inc CurrentSince Aug 8, 2017 Accepting new patients

Locations

15 Council Moore Rd
Crawfordville, FL 32327
Phone (850) 926-7105

1309 Thomasville Rd
Tallahassee, FL 32303
Phone (850) 431-5910

1401 Centerville Rd
Ste 400
Tallahassee, FL 32308
Phone (850) 431-3360

1300 Miccosukee Rd
Tallahassee, FL 32308
Phone (850) 431-1155

3900 Esplanade Way
Tallahassee, FL 32311
Phone (850) 431-3867

1609 Physicians Dr
Tallahassee, FL 32308
Phone (850) 431-4243

Interoperability endpoints

  • Direct secure messaging: svennelaganti21692@tallahasseememorial.direct-ci.com

Organizations & group practices 3

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": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484524800000",
    "number": "1265728851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E 104TH ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641314517",
            "telephone_number": "816-502-8752",
            "fax_number": "816-932-9670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12300 METCALF AVE",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662131324",
            "telephone_number": "816-932-0340",
            "fax_number": "816-932-3148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENNELAGANTI",
        "first_name": "SREEKAR",
        "middle_name": "RAGHURAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-22",
        "last_updated": "2017-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "0437305",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "KS",
            "license": "04-37305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.