Individual provider Active NPI

Sandeep K. Chilakala, MD

  • Neonatal-Perinatal Medicine Physician
  • Memphis, TN
National Provider Identifier
1487835229
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
49878 Issued in TN
Practice address
853 Jefferson Avenue, Suite 201
Memphis, TN 38103
Phone
(901) 448-4750
Fax
(901) 302-2993
NPI assigned
Nov 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 49878 TN Primary

Addresses

Primary practice location

853 Jefferson Avenue, Suite 201
Memphis, TN 38103

Mailing address

1068 Cresthaven Rd Ste 300
Memphis, TN 38119-0809

Other identifiers 6

IdentifierTypeStateIssuer
003180578AMedicaidGA
00422575MedicaidMS
179200MedicaidAL
1487835229MedicaidMO
1532717MedicaidTN
196437001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20130607000549 TN Practitioner - Pediatric Medicine 6608014352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut Medical Group IncGroup PAC ID 3173435369, 98 clinicians

Practice addresses (Care Compare)

877 Jefferson Ave
Memphis, TN 38103-2807
Phone (901) 866-8053

930 Madison Ave
Memphis, TN 38103-3410

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49878TNMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Medical Group, Inc. CurrentSince Jun 1, 2013 Accepting new patients
Ut Medical Group Inc Neonatal-Perinatal Medicine CurrentSince Jun 1, 2013 Accepting new patients
Shelby County Health Care Corporation Past Accepting new patients
Methodist Healthcare - Memphis Hospitals Past Accepting new patients
Amisub (SFH), Inc. Past Accepting new patients

Locations

1068 Cresthaven Rd
Ste 300
Memphis, TN 38119
Phone (901) 683-0024

930 Madison Ave
Ste 200
Memphis, TN 38103
Phone (901) 448-6650

853 Jefferson Ave
Ste 201
Memphis, TN 38103
Phone (901) 448-4750

1407 Union Ave
Ste 700
Memphis, TN 38104
Phone (901) 866-8360

Interoperability endpoints

  • Direct secure messaging: schilakala32772@mlh.direct-ci.com
  • FHIR API: https://epicproxy.et1342.epichosted.com/APIProxyPRD/MLH/api/FHIR/R4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1195516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1487835229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1068 CRESTHAVEN RD STE 300",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381190809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "853 JEFFERSON AVENUE, SUITE 201",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38103",
            "telephone_number": "901-448-4750",
            "fax_number": "901-302-2993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILAKALA",
        "first_name": "SANDEEP",
        "middle_name": "K.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-20",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "TN",
            "license": "49878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003180578A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00422575",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179200",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487835229",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1532717",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196437001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.