Sivaprasad D Madduri, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

R7648 Issued in MO

Practice address

2210 Barron Rd
Suite 216
Poplar Bluff, MO 63901-1908

Phone

(573) 686-4133

Fax

(573) 686-1298

NPI assigned

Jan 4, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MO

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

Urology

Education

Other, 1965

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Semo Gynecology LLC

  • Gynecology Physician
  • Poplar Bluff, MO
  • NPI 1205889227
  NPD
• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)
• Urologic Clinics of North Alabama PC

  • Urology Physician
  • Ocala, FL
  • NPI 1326116468
  NPD (past)

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380585600000",
    "number": "1447238035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 BARRON RD",
            "address_2": "SUITE 216",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639011908",
            "telephone_number": "573-686-4133",
            "fax_number": "573-686-1298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 BARRON RD",
            "address_2": "SUITE 216",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639011908",
            "telephone_number": "573-686-4133",
            "fax_number": "573-686-1298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDURI",
        "first_name": "SIVAPRASAD",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2013-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MO",
            "license": "R7648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS MEDICAID",
            "identifier": "108024001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200297117",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lydia Alpha Mabbitt, LPC
• Daron Knol Mackinder, BAS
• Betty Macleod, RN
• Virginia J Maclin, A.P.N.
• Madad Ali, MD
• Linda D. Magruder, LPC
• Karan Mahal
• Lance T Majors, MD
• Ashley Malkowski, PHARMD
• Nikki Marie Malley, FNP

• Urology Physician in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Urology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2013; 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.