Individual provider Active NPI

Srinivasareddy Vuyyuru, MD

  • Internal Medicine Physician
  • Augusta, GA
National Provider Identifier
1609034461
Registry record updated Aug 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
40279 Issued in AZ
Practice address
1350 Walton Way
Augusta, GA 30901-2612
Phone
(706) 774-5795
Fax
(706) 774-5792
NPI assigned
May 29, 2008
Last updated
Aug 6, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 40279 AZ Primary

Addresses

Primary practice location

1350 Walton Way
Augusta, GA 30901-2612

Mailing address

PO Box 1705
Augusta, GA 30903-1705
Phone (706) 774-7263

Other practice location 1

4530 E Muirwood Dr
Suite 105
Phoenix, AZ 85048-7639
Phone (480) 961-2303

Other practice location 2

4530 E Muirwood Dr
Suite 105
Phoenix, AZ 85048-7639
Phone (480) 961-2303

Other practice location 3

2260 Wrightsboro Rd
Augusta, GA 30904-4764
Phone (706) 481-7000

Other identifiers 1

IdentifierTypeStateIssuer
371108MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GU
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

Enrollment IDStateProvider typePAC IDDetails
I20221221001072 GU Practitioner - Internal Medicine 6204904980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guam Memorial HospitalGroup PAC ID 5890781694, 132 clinicians

Practice addresses (Care Compare)

850 Gov Carlos Camacho Rd
Tamuning, GU 96913-3128

850 Gov Carlos G Camacho Rd
Tamuning, GU 96913-3128
Phone (671) 647-2552

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.81 of 100Reported as group
Quality
83.57
Improvement activities
40
Cost
76.16

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Guam Memorial Hospital CurrentSince Aug 31, 2022 Accepting new patients
Guam Memorial Hospital CurrentSince Aug 31, 2022 Accepting new patients
Wake Forest University Health Sciences Past Accepting new patients

Locations

850 Gov Carlos G Camacho Rd
Tamuning, GU 96913
Phone (671) 647-2555

850 Gov Carlos G Camacho Rd
#R
Tamuning, GU 96913
Phone (671) 647-2552

Organizations & group practices 3

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 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": "1212019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533513600000",
    "number": "1609034461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1705",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309031705",
            "telephone_number": "706-774-7263",
            "fax_number": "706-774-7230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 WALTON WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012612",
            "telephone_number": "706-774-5795",
            "fax_number": "706-774-5792"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4530 E Muirwood Dr",
            "address_2": "Suite 105",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850487639",
            "country_code": "US",
            "telephone_number": "480-961-2303",
            "fax_number": "480-961-2306",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4530 E Muirwood Dr",
            "address_2": "Suite 105",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850487639",
            "country_code": "US",
            "telephone_number": "480-961-2303",
            "fax_number": "480-961-2306",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2260 Wrightsboro Rd",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309044764",
            "country_code": "US",
            "telephone_number": "706-481-7000",
            "fax_number": "706-481-7401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VUYYURU",
        "first_name": "SRINIVASAREDDY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-29",
        "last_updated": "2018-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "40279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "371108",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.