Individual provider Active NPI

Sreenadha Rao Davuluri, MD

  • Neurology Physician
  • St Joseph, MO
National Provider Identifier
1487713798
Registry record updated Sep 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MDR6C71 Issued in MO
Practice address
105 Far West Drive
Suite 201
St Joseph, MO 64506-3511
Phone
(816) 271-8182
Fax
(816) 271-8183
NPI assigned
Dec 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 0419788 KS
Neurology Physician 2084N0400X MDR6C71 MO Primary

Addresses

Primary practice location

105 Far West Drive
Suite 201
St Joseph, MO 64506-3511

Mailing address

105 Far West Drive
Suite 201
St Joseph, MO 64506-3511
Phone (816) 271-8182

Other identifiers 3

IdentifierTypeStateIssuer
130019587OtherMORR MEDIACRE
1487713798MedicaidMO
100123200CMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.76 of 100Reported as group
Quality
74.35
Promoting interoperability
100
Improvement activities
40
Cost
74.85

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
81.83
Promoting interoperability
99
Improvement activities
40
Cost
74.61

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MDR6C71MOMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwestern Health Management, Inc. Past Accepting new patients
Heartland Regional Medical Center Neurology Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sreenadha.davuluri@direct.mymlc.com

Organizations & group practices 2

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": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505779200000",
    "number": "1487713798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 FAR WEST DRIVE",
            "address_2": "SUITE 201",
            "city": "ST JOSEPH",
            "state": "MO",
            "postal_code": "645063511",
            "telephone_number": "816-271-8182",
            "fax_number": "816-271-8183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 FAR WEST DRIVE",
            "address_2": "SUITE 201",
            "city": "ST JOSEPH",
            "state": "MO",
            "postal_code": "645063511",
            "telephone_number": "816-271-8182",
            "fax_number": "816-271-8183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVULURI",
        "first_name": "SREENADHA",
        "middle_name": "RAO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2017-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "KS",
            "license": "0419788",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "MDR6C71",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDIACRE",
            "identifier": "130019587",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487713798",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100123200C",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Joseph, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.