NPIMap

Individual provider Active NPI

Saikiran Jonnadula

  • Internal Medicine Physician
  • Baltimore, MD
National Provider Identifier
1417478538
Registry record updated Feb 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D90691 Issued in MD
Practice address
600 N Wolfe St
Baltimore, MD 21287-0005
Phone
(410) 955-5000
NPI assigned
Jun 28, 2017
Last updated
Feb 24, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D90691 MD Primary

Addresses

Primary practice location

600 N Wolfe St
Baltimore, MD 21287-0005

Mailing address

6201 Greenleigh Ave
Middle River, MD 21220-2004
Phone (410) 933-6421

Other practice location 1

1545 Atlantic Ave
Brooklyn, NY 11213-1122
Phone (718) 613-4063

Other identifiers 1

IdentifierTypeStateIssuer
D90691OtherMDLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, MA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210414000898 MD Practitioner - Hospitalist 8921352667 Reassigns benefits to 1 organization
I20220726003430 MA Practitioner - Internal Medicine 8921352667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D90691MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Physicians Organization Inc Internal Medicine CurrentSince Jul 11, 2022 Accepting new patients
Brigham and Women's Hospital Current Accepting new patients
Johns Hopkins University CurrentSince Apr 1, 2021 Accepting new patients
Johns Hopkins University CurrentSince Apr 1, 2021 Accepting new patients
Brigham and Women's Faulkner Hospital Inc Past Accepting new patients

Locations

75 Francis St
Boston, MA 02115

1153 Centre St
Jamaica Plain, MA 02130
Phone (617) 983-7000

254 2nd Ave
Ste 100
Needham Heights, MA 02494
Phone (781) 416-8413

600 N Wolfe St
Baltimore, MD 21287

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

Interoperability endpoints

  • Direct secure messaging: jonnadula.saikiran.bwh@direct.partners.masshiway.net
  • Direct secure messaging: sjonnadula827959@direct.hopkinsmedicine.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1498608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1417478538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004",
            "telephone_number": "410-933-6421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N WOLFE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870005",
            "telephone_number": "410-955-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1545 Atlantic Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112131122",
            "country_code": "US",
            "telephone_number": "718-613-4063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONNADULA",
        "first_name": "SAIKIRAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-28",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D90691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "D90691",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.