Individual provider Active NPI

Srinivas R. Pamidi, MD

  • Cardiovascular Disease Physician
  • Fort Wayne, IN
National Provider Identifier
1598725913
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
01070808A Issued in IN
Practice address
7916 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone
(260) 432-2297
Fax
(260) 434-6433
NPI assigned
Mar 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 01070808A IN Primary

Addresses

Primary practice location

7916 W Jefferson Blvd
Fort Wayne, IN 46804-4140

Mailing address

6920 Pointe Inverness Way Ste 200
Fort Wayne, IN 46804-7934
Phone (260) 479-3514

Other identifiers 1

IdentifierTypeStateIssuer
201062120MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address srinivas.pamidi@lutheranhealthnetwork.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, OH2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20120430000005 IN Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 5395649701 Reassigns benefits to 1 organization
I20141219001921 OH Practitioner - Cardiovascular Disease (Cardiology) 5395649701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lutheran Medical Group LLCGroup PAC ID 4981751617, 251 clinicians

Practice addresses (Care Compare)

1035 W Wayne St
Paulding, OH 45879-1544
Phone (419) 399-4080

2516 E Dupont Rd
Fort Wayne, IN 46825-1608
Phone (260) 434-6076

7916 W Jefferson Blvd
Fort Wayne, IN 46804-4140

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.99 of 100Reported as apm
Quality
77.41
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Medical Group LLC CurrentSince May 1, 2012 Accepting new patients
Lutheran Medical Group LLC Cardiovascular Disease CurrentSince May 1, 2012 Accepting new patients
Franklin Cardiac Center LLC Past Accepting new patients
Brookfield Heart and Vascular Cardiovascular Disease Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Wisconsin Heart and Vascular Clinics SC Past Accepting new patients
Commonwealth Medical Group, LLC Cardiovascular Disease Past Accepting new patients

Locations

955 High St
Ste 3
Decatur, IN 46733
Phone (219) 724-2125

2516 E DuPont Rd
Fort Wayne, IN 46825
Phone (260) 434-6076

7916 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 432-2298

6920 Pointe Inverness Way
Ste 200
Fort Wayne, IN 46804
Phone (260) 479-3514

1035 W Wayne St
Paulding, OH 45879
Phone (419) 399-4080

Organizations & group practices 7

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 5

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1598725913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6920 POINTE INVERNESS WAY STE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047934",
            "telephone_number": "260-479-3514",
            "fax_number": "260-479-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7916 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044140",
            "telephone_number": "260-432-2297",
            "fax_number": "260-434-6433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAMIDI",
        "first_name": "SRINIVAS",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IN",
            "license": "01070808A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201062120",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "srinivas.pamidi@lutheranhealthnetwork.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "7916 W Jefferson Blvd",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468044140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.