Mamatha Sirivol, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2024-00275 Issued in NC

Practice address

350 N Cox St Ste 28
Asheboro, NC 27203-5514

Phone

(336) 629-6500

Fax

(336) 629-9500

NPI assigned

May 21, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WI, ME, NC3 enrollments

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 3

Specialty

Family Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Moses Cone Affiliated Physicians, Inc.Group PAC ID 3779635396, 80 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Moses Cone Affiliated Physicians, Inc

  • Obstetrics & Gynecology Physician
  • Greensboro, NC
  • NPI 1346474103

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Ascension Medical Group-Southeast Wisconsin Inc

  • Internal Medicine Physician
  • Glendale, WI
  • NPI 1609881077

  Family Medicine

  Medicare reassignment NPD
• Moses Cone Affiliated Physicians, Inc.

  • Gynecology Physician
  • Greensboro, NC
  • NPI 1417610627
  NPD
• Moses Cone Affiliated Physicians, Inc.

  • Family Medicine Physician
  • Asheboro, NC
  • NPI 1437643988
  NPD

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

{
    "created_epoch": "1242864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1508091489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 WHITING HILL RD STE 300",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121006",
            "telephone_number": "207-973-5035",
            "fax_number": "207-973-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 N COX ST STE 28",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272035514",
            "telephone_number": "336-629-6500",
            "fax_number": "336-629-9500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7 Main Rd N",
            "address_purpose": "LOCATION",
            "city": "Hampden",
            "state": "ME",
            "postal_code": "044441334",
            "country_code": "US",
            "telephone_number": "207-862-9400",
            "fax_number": "207-862-9411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIRIVOL",
        "first_name": "MAMATHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-21",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "57322-20",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "MD21574",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2024-00275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Yvette Simmons, MBA, DBA
• John Larry Simpson, M.D.
• Kami L Simpson
• Mini Hanspal Singh, LPT
• Josh Wayne Sink, MA, LCMHCA
• Lance Thayer Sisco, MD
• Sistasis Family Practice,Inc.
• Jim Sistasis, M.D.
• Rowena Maria Sistasis, M.D.
• Jodi Skeen, MA CCC-SLP

• Family Medicine Physician in Asheboro, NC
• Providers in Asheboro, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.