Sarode K Pundaleeka, MD

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

036052030 Issued in IL

Practice address

2614 W Jefferson St
Joliet, IL 60435

Phone

(815) 725-1355

Fax

(815) 725-9857

NPI assigned

Sep 20, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Community Imaging LLC

  • Radiology Clinic/Center
  • Bellwood, IL
  • NPI 1609958719
  NPD (past)
• Reflections DME Boutique

  • Customized Equipment (DME)
  • Joliet, IL
  • NPI 1770229445
  NPD (past)

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327017600000",
    "number": "1447245071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2614 W JEFFERSON ST",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "60435",
            "telephone_number": "815-725-1355",
            "fax_number": "815-725-9857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2614 W JEFFERSON ST",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "60435",
            "telephone_number": "815-725-1355",
            "fax_number": "815-725-9857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUNDALEEKA",
        "first_name": "SARODE",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2012-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IL",
            "license": "036052030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIV ID# FOR GROUP 205474",
            "identifier": "L98065",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "830000578",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036052030",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIV ID# FOR GROUP 336140",
            "identifier": "L29320",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alayna Pullara, DOT, OTR/L
• Mark Pullara, ATC
• Martine Louise Pullara, OTRL
• Davisha Pulley, MSW
• Donna A Pullman, CRNFA
• Anuj S. Puppala, M.D.
• Corinne Ann Puriski, M.S.,CCC-SLP
• Sakina Syeda Quadri
• Quality DRT LLC
• Jeriel Marsena Quarles, LPN

• Hematology & Oncology Physician in Joliet, IL
• Providers in Joliet, IL by specialty
• Hematology & Oncology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.