NPIMap

Individual provider Active NPI

Srinivas Reddy Pulagam, MD

  • Hospitalist Physician
  • Grand Forks, ND
National Provider Identifier
1366516833
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
C129613 Issued in CA
Practice address
1000 S Columbia Rd
Grand Forks, ND 58201-4036
Phone
(701) 780-6000
Fax
(701) 780-1942
NPI assigned
Nov 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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 10277 ND
Hospitalist Physician 208M00000X C129613 CA Primary

Addresses

Primary practice location

1000 S Columbia Rd
Grand Forks, ND 58201-4036

Mailing address

PO Box 6002
Grand Forks, ND 58206-6002
Phone (701) 780-6000

Other identifiers 1

IdentifierTypeStateIssuer
13994MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151016001863 CA Practitioner - Internal Medicine 7517967482 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Enloe Medical CenterGroup PAC ID 9739092388, 330 clinicians

Practice addresses (Care Compare)

1531 Esplanade
Chico, CA 95926-3310
Phone (530) 332-5557

Hospital & facility affiliations

  • Butte Home Health and Hospice Home health agency, Chico, CA, CCN 057679
  • Enloe Health Hospital, Chico, CA, CCN 050039
  • Oroville Hospital Hospital, Oroville, CA, CCN 050030
  • Adventist Health Clearlake Hospital, Clearlake, CA, CCN 051317
  • Orchard Hospital Hospital, Gridley, CA, CCN 051311
  • St Elizabeth Community Hospital Hospital, Red Bluff, CA, CCN 050042

Merit-based Incentive Payment System (MIPS)

Final score
81.49 of 100Reported as group
Quality
60.52
Promoting interoperability
100
Improvement activities
40
Cost
68.7

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10277NDMDInternal Medicine Physician
C129613CAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Enloe Medical Center Current Accepting new patients
Enloe Medical Center CurrentSince Aug 1, 2023 Accepting new patients
Enloe Medical Center CurrentSince Aug 1, 2023 Accepting new patients

Locations

888 Lakeside Vlg Cmns
Chico, CA 95928
Phone (530) 332-6800

Interoperability endpoints

  • Direct secure messaging: spulagam15401@enloedirect.org

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 7

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": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1366516833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6002",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582066002",
            "telephone_number": "701-780-6000",
            "fax_number": "701-780-1942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S COLUMBIA RD",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014036",
            "telephone_number": "701-780-6000",
            "fax_number": "701-780-1942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULAGAM",
        "first_name": "SRINIVAS",
        "middle_name": "REDDY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ND",
            "license": "10277",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "C129613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13994",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

Verify at the official NPI Registry.