NPIMap

Individual provider Active NPI

Srikanth Mahavadi, DPM

  • Foot Surgery Podiatrist
  • Providence Forge, VA
National Provider Identifier
1487610341
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
0103001025 Issued in VA
Practice address
9050 Pocahontas TRL
Ste#F
Providence Forge, VA 23140-3400
Phone
(804) 966-8350
Fax
(804) 966-8999
NPI assigned
Apr 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X 0103001025 VA Primary

Addresses

Primary practice location

9050 Pocahontas TRL
Ste#F
Providence Forge, VA 23140-3400

Mailing address

PO Box 357
Providence Forge, VA 23140-0357
Phone (804) 966-8350

Other identifiers 1

IdentifierTypeStateIssuer
009301429MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20040726000989 VA Practitioner - Podiatry 9830179126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3660 Boulevard
Suite I
Colonial Heights, VA 23834-1345
Phone (804) 722-0467

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue480
Removal of skin lesions1-10
Removal of nail tissue519
Removal or shaving of skin growth386
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0103001025VAMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Srikanth Mahavadi Foot Surgery Current Accepting new patients
Dominion Medical Center, LLC Past Accepting new patients
Heal Health Orthopaedics and Urgent Care Clinics PLLC PastSince Jul 15, 2010 Accepting new patients
Cardio Vascular Center, LLC Past Accepting new patients

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 5

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": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487610341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 357",
            "city": "PROVIDENCE FORGE",
            "state": "VA",
            "postal_code": "231400357",
            "telephone_number": "804-966-8350",
            "fax_number": "804-966-8999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9050 POCAHONTAS TRL",
            "address_2": "STE#F",
            "city": "PROVIDENCE FORGE",
            "state": "VA",
            "postal_code": "231403400",
            "telephone_number": "804-966-8350",
            "fax_number": "804-966-8999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAVADI",
        "first_name": "SRIKANTH",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "VA",
            "license": "0103001025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009301429",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence Forge, VA

Sources for this page

Verify at the official NPI Registry.