Siva Pavani Nallam, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD462023 Issued in PA

Practice address

2349 N California St
Stockton, CA 95204-5505

Phone

(209) 469-2229

Fax

(209) 466-2436

NPI assigned

Dec 12, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Siva Pavani Puppala Former name

Medicare fee-for-service enrollment

Enrolled in CA

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: snallam768458@direct.ochin.org
• Direct secure messaging: siva.puppala.p1@direct.cmcentersinc.nextgenshare.com

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 Medical Centers, Inc.

  dba Esparto Family Practice

  • Federally Qualified Health Center (FQHC)
  • Esparto, CA
  • NPI 1588729180
  Medicare reassignment NPD
• Community Medical Centers Inc

  dba Community Medical Centers, Lodi East

  • Federally Qualified Health Center (FQHC)
  • Lodi, CA
  • NPI 1891529061
  NPD
• Community Medical Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Stockton, CA
  • NPI 1649525544
  NPD

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

{
    "created_epoch": "1386806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1659702819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2349 N CALIFORNIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045505",
            "telephone_number": "630-877-7629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2349 N CALIFORNIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045505",
            "telephone_number": "209-469-2229",
            "fax_number": "209-466-2436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NALLAM",
        "first_name": "SIVA PAVANI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-12",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A161250",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD462023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SIVA PAVANI",
            "last_name": "PUPPALA",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Darin K Nakamura, D.D.S.
• Robert Mitsuo Nakamura, DDS
• Alan S Nakanishi, M.D.
• Corey Michael Nakata, RPH
• Bhagya Nakka, MD
• Namaste Counseling Services
• Linda Sumiko Namba-Garcia, PHARMD
• Dhiren V. Nanavati, MD
• Josephine Lynne Nance, PT
• Rachel Nance

• Pediatrics Physician in Stockton, CA
• Providers in Stockton, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; 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.