NPIMap

Individual provider Active NPI

Srinivas Sai Mikkilineni, M.D.

  • Interventional Cardiology Physician
  • Hickory, NC
National Provider Identifier
1558595108
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
2012-01404 Issued in NC
Practice address
2660 Tate Blvd SE
Hickory, NC 28602-1465
Phone
(828) 261-0009
Fax
(828) 261-0799
NPI assigned
May 12, 2009
Last updated
Sep 14, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2012-01404 NC
Interventional Cardiology Physician 207RI0011X 2012-01404 NC Primary

Addresses

Primary practice location

2660 Tate Blvd SE
Hickory, NC 28602-1465

Mailing address

1850 W Arlington Blvd
Greenville, NC 27834-5704
Phone (252) 752-6101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120928000451 NC Practitioner - Interventional CardiologyPractitioner - Internal Medicine 9133378540 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DLP Frye Medical Group LLCGroup PAC ID 8123397601, 125 clinicians

Practice addresses (Care Compare)

2660 Tate Blvd SE
Hickory, NC 28602-1465
Phone (828) 261-0009

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2012-01404NCMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Frye Medical Group LLC Interventional Cardiology CurrentSince May 1, 2021 Accepting new patients
DLP Frye Medical Group LLC CurrentSince May 1, 2021 Accepting new patients
DLP Cardiology Physicians LLC Past Accepting new patients

Locations

2660 Tate Blvd SE
Hickory, NC 28602
Phone (828) 261-0009

915 Tate Blvd SE
Ste 182
Hickory, NC 28602
Phone (828) 322-2005

915 Tate Blvd SE
Ste 186
Hickory, NC 28602
Phone (828) 449-8458

Interoperability endpoints

  • Direct secure messaging: srinivas.mikkilineni.1@15786.direct.athenahealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1242086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1558595108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 W ARLINGTON BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345704",
            "telephone_number": "252-752-6101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2660 TATE BLVD SE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286021465",
            "telephone_number": "828-261-0009",
            "fax_number": "828-261-0799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKKILINENI",
        "first_name": "SRINIVAS",
        "middle_name": "SAI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-12",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2012-01404",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NC",
            "license": "2012-01404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.