Individual provider Active NPI

Sitarama Pochiraju, MD

  • Internal Medicine Physician
  • Mentor, OH
National Provider Identifier
1487632253
Registry record updated Aug 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35077720 Issued in OH
Practice address
7350 Industrial Park Blvd
Mentor, OH 44060-5318
Phone
(216) 732-9480
NPI assigned
Jan 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2010

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 35077720 OH Primary

Addresses

Primary practice location

7350 Industrial Park Blvd
Mentor, OH 44060-5318

Mailing address

PO Box 1500
Novi, MI 48376-1500
Phone (248) 324-0700

Other identifiers 3

IdentifierTypeStateIssuer
2190070MedicaidOH
657406OtherOHANTHEM
110201423OtherOHRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20100224000070 OH Practitioner - Internal Medicine 0244374650 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35077720OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC Internal Medicine CurrentSince Mar 9, 2000 Accepting new patients
Vpa PC Internal Medicine CurrentSince Mar 9, 2000 Accepting new patients
Vpa PC Internal Medicine Current Accepting new patients
Vpa PC Internal Medicine Current Accepting new patients
Vpa PC Internal Medicine Current Accepting new patients
Vpa PC Internal Medicine Current Accepting new patients

Locations

4435 Aicholtz Rd
Ste 400
Cincinnati, OH 45245
Phone (513) 326-3007

355 E Campus View Blvd
Ste 180
Columbus, OH 43235
Phone (614) 523-2155

3500 Massillon Rd
Ste 280
Green, OH 44685
Phone (330) 896-5651

7350 Industrial Park Blvd
Mentor, OH 44060
Phone (216) 732-9480

3033 Kettering Blvd
Ste 100
Moraine, OH 45439
Phone (937) 293-2133

7206 Market St
Ste A
Youngstown, OH 44512
Phone (330) 726-3379

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281398400000",
    "number": "1487632253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1500",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483761500",
            "telephone_number": "248-324-0700",
            "fax_number": "248-324-1477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7350 INDUSTRIAL PARK BLVD",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440605318",
            "telephone_number": "216-732-9480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POCHIRAJU",
        "first_name": "SITARAMA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2010-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35077720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2190070",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "657406",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110201423",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

Verify at the official NPI Registry.