Organization Active NPI

Sai Vittala PLLC

  • Psychiatry Physician
  • Fort Worth, TX
National Provider Identifier
1497134332
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
SAI VITTALA PLLC
Practice address
5560 Mesa Springs Dr
Fort Worth, TX 76123-2120
Phone
(817) 292-4600
NPI assigned
May 26, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Dr. Ramakrishna VeluriNPI 1033525050
Title
MD
Phone
(682) 477-3534

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Geriatric Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0805X

Addresses

Primary practice location

5560 Mesa Springs Dr
Fort Worth, TX 76123-2120

Mailing address

2600 E Southlake Blvd Ste 120354
Southlake, TX 76092-6634
Phone (682) 477-3534

Other identifiers 1

IdentifierTypeStateIssuer
Q3302OtherTXMEDICAL LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150804003213 TX Part B Supplier - Clinic/Group Practice 3678887791 Receives reassigned benefits from 3 practitioners
Practice locations: Arlington, TX; Fort Worth, TX

National Provider Directory

National Provider Directory

Locations

2600 E Southlake Blvd
#120354
Southlake, TX 76092

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1432598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1497134332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 E SOUTHLAKE BLVD STE 120354",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926634",
            "telephone_number": "682-477-3534",
            "fax_number": "682-477-3602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5560 MESA SPRINGS DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761232120",
            "telephone_number": "817-292-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAI VITTALA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-26",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "VELURI",
        "authorized_official_first_name": "RAMAKRISHNA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "682-477-3534",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "Q3302",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.