Sreya Talasila, M.D.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

01085876A Issued in IN

Practice address

3190 Lancer St
Portage, IN 46368-4488

Phone

(219) 764-3600

NPI assigned

Apr 1, 2014

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

Medicare fee-for-service enrollment

Enrolled in IL, IN, FL3 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 3

Specialty

DermatologyAlso: Micrographic Dermatologic Surgery (MDS)

Education

George Washington University School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Illinois Dermatology Institute, LLCGroup PAC ID 7911043054, 51 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: stalasila@illinois.emadirect.md

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.

• Illinois Dermatology Institute, LLC

  • Dermatology Physician
  • Skokie, IL
  • NPI 1891920898

  IN

  Medicare reassignment Care Compare group
• Premier Dermatology, LLC

  • Dermatology Physician
  • Sarasota, FL
  • NPI 1700202298
  Medicare reassignment
• Northern Indiana Dermatology and Skin Surgery Center

  • MOHS-Micrographic Surgery Physician
  • Portage, IN
  • NPI 1639289093
  NPD (past)
• Physicians Dermpath Laboratory

  • Dermatopathology Physician
  • Park Ridge, IL
  • NPI 1376866897
  NPD (past)
• Pinnacle Dermatology, SC

  • Dermatology Physician
  • Joliet, IL
  • NPI 1861930984
  NPD (past)

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

{
    "created_epoch": "1396310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627171200000",
    "number": "1366860884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3190 LANCER ST",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463684488",
            "telephone_number": "219-764-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3190 LANCER ST",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463684488",
            "telephone_number": "219-764-3600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 N Elm St Ste 250",
            "address_purpose": "LOCATION",
            "city": "Hinsdale",
            "state": "IL",
            "postal_code": "605213647",
            "country_code": "US",
            "telephone_number": "630-325-6880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TALASILA",
        "first_name": "SREYA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-01",
        "last_updated": "2021-07-25",
        "certification_date": "2021-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036.146276",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "IN",
            "license": "01085876A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori F Stewart, LPT
• Nonie Veronica Sullivan, ARNP
• Carolyn Sweezer
• Dean A. Szabo, O.D.
• Ronald William Szabo, O.D.
• Shirley Taylor
• Sonya C Tener, COTA
• Terria Conwell (ACL Medical Supply)
• The Dialysis Center of Portage LLC (Portage Dialysis Center)
• The Woman's Wellness Center, P.C.

• MOHS-Micrographic Surgery Physician in Portage, IN
• Providers in Portage, IN by specialty
• MOHS-Micrographic Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2021; 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.