Individual provider Active NPI

Spandana Lavanya Daryani

  • Dermatology Physician
  • Portland, OR
National Provider Identifier
1295313484
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD225768 Issued in OR
Practice address
3303 S Bond Ave
Portland, OR 97239-4501
Phone
(503) 418-3376
NPI assigned
Mar 30, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dermatology Physician 207N00000X MD225768 OR Primary

Addresses

Primary practice location

3303 S Bond Ave
Portland, OR 97239-4501

Mailing address

3303 S Bond Ave
Portland, OR 97239-4501
Phone (503) 418-3376

Other practice location 1

100 E Lancaster Ave
Wynnewood, PA 19096-3450
Phone (484) 476-2658

Other names 1

  • Spandana Maddukuri Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20250918004324 OR Practitioner - Dermatology 6204237829 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Rutgers New Jersey Medical School, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

3303 S Bond Ave
Portland, OR 97239-4501
Phone (503) 494-8311

Hospital & facility affiliations

  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions89
Skin biopsy39

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD225768ORMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Aug 1, 2025 Accepting new patients
University Professional Services CurrentSince Aug 1, 2025 Accepting new patients
University Professional Services Current Accepting new patients
University Professional Services Past Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

3303 S Bond Ave
Portland, OR 97239
Phone (503) 494-3151

Interoperability endpoints

  • Direct secure messaging: smaddukuri142477@direct.ohsu.edu

Organizations & group practices 4

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": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756425600000",
    "number": "1295313484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303 S BOND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394501",
            "telephone_number": "503-418-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 S BOND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394501",
            "telephone_number": "503-418-3376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 E Lancaster Ave",
            "address_purpose": "LOCATION",
            "city": "Wynnewood",
            "state": "PA",
            "postal_code": "190963450",
            "country_code": "US",
            "telephone_number": "484-476-2658",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DARYANI",
        "first_name": "SPANDANA",
        "middle_name": "LAVANYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-30",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OR",
            "license": "MD225768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SPANDANA",
            "last_name": "MADDUKURI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.