Individual provider Active NPI

Srikant Polepalli, M.D.

  • Hospitalist Physician
  • Staten Island, NY
National Provider Identifier
1528297728
Registry record updated Dec 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
266591 Issued in NY
Practice address
475 Seaview Ave
Staten Island, NY 10305-3436
Phone
(718) 226-9000
NPI assigned
Jul 8, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 266591 NY Primary

Addresses

Primary practice location

475 Seaview Ave
Staten Island, NY 10305-3436

Mailing address

475 Seaview Ave
Staten Island, NY 10305-3436
Phone (718) 226-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121029000016 NY Practitioner - HospitalistPractitioner - Internal Medicine 2668622606 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

475 Seaview Ave
Staten Island, NY 10305-3436
Phone (212) 434-6980

Hospital & facility affiliations

  • Staten Island University Hospital Hospital, Staten Island, NY, CCN 330160

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
266591NYMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians of University Hospital, PC CurrentSince Oct 23, 2012 Accepting new patients
North Shore-Lij Medical PC Hospitalist CurrentSince Jun 1, 2019 Accepting new patients
Physicians of University Hospital, PC CurrentSince Oct 23, 2012 Accepting new patients
Staten Island University Hospital Past Accepting new patients

Locations

300 Community Dr
Plandome, NY 11030

401 Seaview Ave
Lowr
Staten Island, NY 10305
Phone (718) 226-6186

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

1 Edgewater St
Fl 6
Staten Island, NY 10305
Phone (718) 226-1047

242 Mason Ave
Staten Island, NY 10305
Phone (718) 226-1458

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: spolepalli66371@northwell.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1247011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544659200000",
    "number": "1528297728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053436",
            "telephone_number": "718-226-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053436",
            "telephone_number": "718-226-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLEPALLI",
        "first_name": "SRIKANT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-08",
        "last_updated": "2018-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "266591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.