Siva Sundeep Koppolu, MBBS

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

E-15382 Issued in AR

Practice address

3401 Springhill Dr Ste 490
North Little Rock, AR 72117-2933

Phone

(501) 945-8838

Fax

(501) 945-8835

NPI assigned

Sep 1, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

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

Specialty

PsychiatryAlso: Pain Management

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Arkansas Health GroupGroup PAC ID 7911802079, 645 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Medical Center North Little Rock Hospital, North Little Rock, AR, CCN 040036

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: skoppolu675051@direct.baptist-healthar.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.

• Arkansas Health Group

  • Psychiatry Physician
  • Bryant, AR
  • NPI 1871959874
  Medicare reassignment Care Compare group NPD
• Arkansas Health Group

  • Obstetrics & Gynecology Physician
  • Arkadelphia, AR
  • NPI 1720417835
  NPD
• Arkansas Health Group

  • Surgery Physician
  • Stuttgart, AR
  • NPI 1952840555
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Health

  • General Acute Care Hospital
  • North Little Rock, AR
  • NPI 1497790042
  Care Compare affiliation

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1316493943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 EXECUTIVE CENTER DR STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114393",
            "telephone_number": "501-945-8838",
            "fax_number": "501-945-8835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 SPRINGHILL DR STE 490",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721172933",
            "telephone_number": "501-945-8838",
            "fax_number": "501-945-8835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPPOLU",
        "first_name": "SIVA SUNDEEP",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-01",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NE",
            "license": "TEP 7768",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AR",
            "license": "E-15382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Lynn Knight, ST
• Shravya Krishna Kokkula
• Alissa Kolb, PSY.D.
• Suraj Kolluru
• Dierna Koon
• Kori Lynne Kornet, MD, MPH
• Erica Louise Kosmach, B.S., MHPP
• Vinisha Reddy Kota, M.D.
• Sujit Kumar Kotapati, M.D
• Vijaya Padma Kotapati, MD

• Psychiatry Physician in North Little Rock, AR
• Providers in North Little Rock, AR by specialty
• Psychiatry Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; 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.

Verify at the official NPI Registry.