Individual provider Active NPI

Sreeshma Tellapuri, MD

  • Diagnostic Neuroimaging (Radiology) Physician
  • Chicago, IL
National Provider Identifier
1336701770
Registry record updated Jul 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Neuroimaging (Radiology) PhysicianTaxonomy code 2085D0003X
License
125073574 Issued in IL
Practice address
1653 W Congress Pkwy
Chicago, IL 60612-3833
Phone
(312) 942-4184
NPI assigned
Jul 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Neuroimaging (Radiology) Physician 2085D0003X 125073574 IL Primary

Addresses

Primary practice location

1653 W Congress Pkwy
Chicago, IL 60612-3833

Mailing address

33 S Ashland Ave Apt 311
Chicago, IL 60607-1849
Phone (510) 936-4119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231002002423 IL Practitioner - Diagnostic Radiology 9032445507 Reassigns benefits to 1 organization
I20260406000344 IA Practitioner - Diagnostic Radiology 9032445507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lucidsolutions IncGroup PAC ID 0749603462, 84 clinicians

Practice addresses (Care Compare)

515 College St
Cedar Falls, IA 50613-2500
Phone (319) 272-7070

824 Belleforte Ave
Oak Park, IL 60302-1502
Phone (319) 272-7070

Hospital & facility affiliations

  • Mercyone Waterloo Medical Center Hospital, Waterloo, IA, CCN 160067
  • Sartori Memorial Hospital, Inc Hospital, Cedar Falls, IA, CCN 160040
  • Allen Hospital Hospital, Waterloo, IA, CCN 160110

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lucidsolutions, Inc. CurrentSince Sep 1, 2023 Accepting new patients
Riverside Radiology and Interventional Associates Inc CurrentSince Sep 1, 2023 Accepting new patients

Locations

515 College St
Cedar Falls, IA 50613
Phone (319) 268-3000

Interoperability endpoints

  • Direct secure messaging: stellapuri3937513@direct.trinity-health.org

Organizations & group practices 2

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 3

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": "1562371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562371200000",
    "number": "1336701770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 S ASHLAND AVE APT 311",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071849",
            "telephone_number": "510-936-4119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123833",
            "telephone_number": "312-942-4184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELLAPURI",
        "first_name": "SREESHMA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-06",
        "last_updated": "2019-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085D0003X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Neuroimaging",
            "state": "IL",
            "license": "125073574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.