Srinivas M Ammisetty, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

35594 Issued in KY

Practice address

9350 US Hwy 23 South
Suite 104
Stanville, KY 41659

Phone

(606) 478-1005

Fax

(606) 478-8687

NPI assigned

Oct 25, 2006

Last updated

Apr 7, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

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

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.

• East Ky Pulmonary & Sleep Disorder Ctr.

  • Pulmonary Disease Physician
  • Stanville, KY
  • NPI 1013063106
  Authorized official Same address or phone
• East Ky Pulmonary & Associates

  • Internal Medicine Physician
  • Pikeville, KY
  • NPI 1821109810

  Pulmonary Disease

  NPD (past)
• R.V. Mettu,M.D PSC

  • Sleep Medicine (Internal Medicine) Physician
  • Pikeville, KY
  • NPI 1346351319
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586217600000",
    "number": "1689758799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9350 US HWY 23 SOUTH",
            "address_2": "P O BOX 70",
            "city": "STANVILLE",
            "state": "KY",
            "postal_code": "41659",
            "telephone_number": "606-478-1005",
            "fax_number": "606-478-8687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9350 US HWY 23 SOUTH",
            "address_2": "SUITE 104",
            "city": "STANVILLE",
            "state": "KY",
            "postal_code": "41659",
            "telephone_number": "606-478-1005",
            "fax_number": "606-478-8687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMMISETTY",
        "first_name": "SRINIVAS",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "KY",
            "license": "35594",
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "KY",
            "license": "35594",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65943516",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• East Ky Pulmonary & Sleep Disorder Ctr.
• Floyd County Health Department
• Goblecare Clinic Inc
• Goblecare Clinic Inc
• Good Doctor

• Pulmonary Disease Physician in Stanville, KY
• Providers in Stanville, KY by specialty
• Pulmonary Disease Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2020; 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.