Vidhya Devi Srinivasan Illuri, MD

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

Q4604 Issued in TX

Practice address

701 S Zarzamora St
San Antonio, TX 78207-5209

Phone

(210) 358-7000

Fax

(210) 358-7406

NPI assigned

Jun 20, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Community Medicine Associates

  dba University Medicine Associates

  • Family Medicine Physician
  • San Antonio, TX
  • NPI 1245313329
  Medicare reassignment NPD
• Pain Management Specialists

  dba Medical Practice

  • Interventional Pain Medicine Physician
  • San Antonio, TX
  • NPI 1922617125
  NPD (past)

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

{
    "created_epoch": "1276992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436227200000",
    "number": "1538480926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 87",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782910087",
            "telephone_number": "210-358-9172",
            "fax_number": "210-358-9183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 S ZARZAMORA ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782075209",
            "telephone_number": "210-358-7000",
            "fax_number": "210-358-7406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILLURI",
        "first_name": "VIDHYA",
        "middle_name": "DEVI SRINIVASAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-20",
        "last_updated": "2015-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "TX",
            "license": "Q4604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Ilic
• Benjamin Paul Iliff, DO
• Illuminate Pediatric Therapy, PLLC
• Illuminated Direction LLC
• Illuminating Possibility LLC
• Jumoke Ilori
• Andrea Marie Iltis, ACNPC-AG
• Joshua Michael Iltis, MD
• Brenda Im, RBT
• Cheongin Im, PHD, MSN, RN

• Endocrinology, Diabetes & Metabolism Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Endocrinology, Diabetes & Metabolism Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.