NPIMap

Individual provider Active NPI

Sireesha Dasari, MD

  • Family Medicine Physician
  • Parkersburg, WV
National Provider Identifier
1386855484
Registry record updated Apr 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
23651 Issued in WV
Practice address
2610 Camden Ave
Parkersburg, WV 26101-5652
Phone
(304) 917-3733
Fax
(304) 917-3744
NPI assigned
May 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 23651 WV Primary

Addresses

Primary practice location

2610 Camden Ave
Parkersburg, WV 26101-5652

Mailing address

PO Box 609
Elizabeth, WV 26143-0609
Phone (304) 275-3301

Other practice location 1

1504 Grand Central Ave
Vienna, WV 26105
Phone (304) 485-7500

Other identifiers 1

IdentifierTypeStateIssuer
381001660MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20091116000629 WV Practitioner - Family Practice 6406994201 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wirt County Health Services Association, IncGroup PAC ID 7810806577, 31 clinicians

Practice addresses (Care Compare)

2610 Camden Ave
Parkersburg, WV 26101-5652
Phone (304) 917-3733

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Parkersburg, WV, CCN 517087
  • Adoration Home Health Home health agency, Vienna, WV, CCN 517074
  • Charleston Area Medical Center Hospital, Charleston, WV, CCN 510022
  • Camden Clark Medical Center Hospital, Parkersburg, WV, CCN 510058
  • Marietta Memorial Hospital Hospital, Marietta, OH, CCN 360147

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wirt County Health Services Association, Inc Family Medicine Current Accepting new patients
Wirt County Health Services Association, Inc Family Medicine Current Accepting new patients

Locations

483 Court St
Elizabeth, WV 26143
Phone (304) 275-3301

2610 Camden Ave
Parkersburg, WV 26101
Phone (304) 428-1161

Organizations & group practices 4

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 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585785600000",
    "number": "1386855484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 609",
            "city": "ELIZABETH",
            "state": "WV",
            "postal_code": "261430609",
            "telephone_number": "304-275-3301",
            "fax_number": "304-275-4798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2610 CAMDEN AVE",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261015652",
            "telephone_number": "304-917-3733",
            "fax_number": "304-917-3744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1504 Grand Central Ave",
            "address_purpose": "LOCATION",
            "city": "Vienna",
            "state": "WV",
            "postal_code": "26105",
            "country_code": "US",
            "telephone_number": "304-485-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DASARI",
        "first_name": "SIREESHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "23651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381001660",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkersburg, WV

Sources for this page

Verify at the official NPI Registry.