Sri Preethi Gunnala, MD

Primary specialty

Diagnostic Neuroimaging (Radiology) PhysicianTaxonomy code 2085D0003X

License

036128403 Issued in IL

Practice address

836 W Wellington Ave
Illinois Masonic Medical Center- Dept of Radiology
Chicago, IL 60657-5147

Phone

(773) 296-7820

NPI assigned

Jul 30, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Sri Preethi Vagvala Former name

Medicare fee-for-service enrollment

Enrolled in AZ

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

Diagnostic Radiology

Education

St. Louis College of Physicians and Surgeons, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Banner Imaging Services LLCGroup PAC ID 1850724386, 122 clinicians

Associated Valley Radiologists, LTDGroup PAC ID 8325388499, 59 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations (25 of 72)

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.

• Associated Valley Radiologists LTD

  • Diagnostic Radiology Physician
  • Glendale, AZ
  • NPI 1932683257
  Medicare reassignment Care Compare group NPD
• Banner Imaging Services LLC

  • Diagnostic Radiology Physician
  • Sun City, AZ
  • NPI 1770139958
  Medicare reassignment Care Compare group NPD
• Banner Hospital Based Physicians Arizona LLC

  • Multi-Specialty Clinic/Center
  • San Tan Valley, AZ
  • NPI 1275889891
  Medicare reassignment NPD
• Banner-University Medical Group

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1508809427

  Family Medicine

  Medicare reassignment NPD
• Page Hospital

  • Critical Access Hospital
  • Page, AZ
  • NPI 1578515789
  Medicare reassignment NPD
• Sonoran Radiology LTD

  • Vascular & Interventional Radiology Physician
  • Mesa, AZ
  • NPI 1033745708

  Diagnostic Radiology

  Medicare reassignment NPD
• Banner Hospital Based Physicians Arizona LLC

  • Multi-Specialty Clinic/Center
  • Page, AZ
  • NPI 1316294242
  NPD
• Banner Hospital Based Physicians Arizona LLC

  • Critical Care Medicine (Internal Medicine) Physician
  • Phoenix, AZ
  • NPI 1780445171
  NPD
• Banner Imaging Services LLC

  • Radiology Clinic/Center
  • Phoenix, AZ
  • NPI 1710733472
  NPD
• Banner Imaging Services LLC

  • Diagnostic Radiology Physician
  • Casa Grande, AZ
  • NPI 1841846920
  NPD
• Banner-University Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Tucson, AZ
  • NPI 1922820935
  NPD
• Page Hospital

  • Rural Health Clinic/Center
  • Page, AZ
  • NPI 1902317829
  NPD

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404259200000",
    "number": "1366608341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 W WELLINGTON AVE",
            "address_2": "ILLINOIS MASONIC MEDICAL CENTER- DEPT OF RADIOLOGY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575147",
            "telephone_number": "772-296-7820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 W WELLINGTON AVE",
            "address_2": "ILLINOIS MASONIC MEDICAL CENTER- DEPT OF RADIOLOGY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575147",
            "telephone_number": "773-296-7820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNNALA",
        "first_name": "SRI PREETHI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-30",
        "last_updated": "2014-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085D0003X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Neuroimaging",
            "state": "IL",
            "license": "036128403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SRI PREETHI",
            "last_name": "VAGVALA",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tanesha Gunn, CLD, CLC
• Tiffany R. Gunn
• Tyler Michael Gunn, M.D.
• Gunnah Care Services Inc
• Mohsin Bin Ahmed Gunnah
• Chrystina Gunnare, PA-C
• Helena Gunnerson
• Samantha Gunning
• Simon Jonathan Gunter
• Mark Gunther, M.D.

• Diagnostic Neuroimaging (Radiology) Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Diagnostic Neuroimaging (Radiology) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; 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.