Srinivas Medical Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036084786 Issued in IL

Legal business name

SRINIVAS MEDICAL INC

Practice address

8721 Carriage Green Drive
Darien, IL 60561-8468

Phone

(630) 888-4815

Fax

(630) 910-4020

NPI assigned

Apr 18, 2012

Organization subpart

No

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

Authorized official

Name

Srinivas-Prasad Reddy Jolepalem, MDNPI 1568531564

Title

Physician

Phone

(630) 888-4815

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Srinivas-Prasad Reddy Jolepalem, M.D.

  • Internal Medicine Physician
  • Darien, IL
  • NPI 1568531564
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367193600000",
    "number": "1689931420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8721 CARRIAGE GREEN DRIVE",
            "city": "DARIEN",
            "state": "IL",
            "postal_code": "605618468",
            "telephone_number": "630-888-4815",
            "fax_number": "630-910-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8721 CARRIAGE GREEN DRIVE",
            "city": "DARIEN",
            "state": "IL",
            "postal_code": "605618468",
            "telephone_number": "630-888-4815",
            "fax_number": "630-910-4020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRINIVAS MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-18",
        "last_updated": "2013-04-29",
        "status": "A",
        "authorized_official_last_name": "JOLEPALEM",
        "authorized_official_first_name": "SRINIVAS-PRASAD",
        "authorized_official_middle_name": "REDDY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "630-888-4815",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036084786",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "32848-20",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01064406A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036084786",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Darien, IL
• Providers in Darien, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.