Sr Nakka MD

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

543686 Issued in CA

Legal business name

SR NAKKA MD

Doing business as

Advanced Endoscopy Center-Gastroenterology

Practice address

25495 Medical Center Dr
Suite 307
Murrieta, CA 92562-4902

Phone

(951) 304-3900

Fax

(951) 304-3901

NPI assigned

Jun 27, 2014

Last updated

Jan 12, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sreenivasa Rao Nakka, M.D.NPI 1184666547

Title

Owner/President

Phone

(951) 929-1177

Specialties & licenses 1

Addresses

Other names 1

• ADVANCED ENDOSCOPY CENTER-GASTROENTEROLOGY Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Advanced Endoscopy Center GastroenterologyCCN 05C0002161

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Naishadh Naval Raghuwanshi, MD, MBA

  • Gastroenterology Physician
  • Murrieta, CA
  • NPI 1588869382
  Medicare reassignment NPD
• Sreenivasa Rao Nakka, M.D,F.A.C.P,F.A.C.G

  • Internal Medicine Physician
  • Hemet, CA
  • NPI 1184666547
  NPD (past) Authorized official

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

{
    "created_epoch": "1403827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452556800000",
    "number": "1366857377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "949 CALHOUN PL",
            "address_2": "SUITE A",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925434403",
            "telephone_number": "951-929-1177",
            "fax_number": "951-765-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25495 MEDICAL CENTER DR",
            "address_2": "SUITE 307",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925624902",
            "telephone_number": "951-304-3900",
            "fax_number": "951-304-3901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SR NAKKA MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-27",
        "last_updated": "2016-01-12",
        "status": "A",
        "authorized_official_last_name": "NAKKA",
        "authorized_official_first_name": "SREENIVASA",
        "authorized_official_middle_name": "RAO",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "951-929-1177",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "543686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ADVANCED ENDOSCOPY CENTER-GASTROENTEROLOGY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gregory B. Spivey
• Lisa Marie Spivey
• Daniel Sprague
• Lois Ann Sprague
• Megan M. Sprague, M.S., B.C.B.A.
• St Luke Cardiovascular Medical Group
• Emily G Stadick, NP
• Maryanne Stafford, DACM
• Taylor Stainer, B.A.
• Meerweis Stanisai

• Ambulatory Surgical Clinic/Center in Murrieta, CA
• Providers in Murrieta, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.