Individual provider Active NPI

Srikrishna Mylavarapu, MD

  • Psychiatry Physician
  • West Allis, WI
National Provider Identifier
1700993136
Registry record updated Jul 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
44856 Issued in WI
Practice address
2424 S 90TH St
West Allis, WI 53227-2455
Phone
(414) 773-4312
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 40767 MN
Psychiatry Physician 2084P0800X 44856 WI Primary

Addresses

Primary practice location

2424 S 90TH St
West Allis, WI 53227-2455

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

5900 S Lake Dr
Cudahy, WI 53110-3171
Phone (414) 489-4125

Other identifiers 1

IdentifierTypeStateIssuer
33349600MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address smylavarapu9624@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20040813001256 WI Practitioner - Psychiatry 9335112739 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056

2424 S 90TH St
West Allis, WI 53227-2455
Phone (414) 328-8630

2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone (414) 646-5410

8901 W Lincoln Ave
West Allis, WI 53227-2409
Phone (414) 329-5930

945 N 12TH St
Milwaukee, WI 53233-1305
Phone (414) 219-7300

Hospital & facility affiliations

  • Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40767MNMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Feb 1, 2003 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Feb 1, 2003 Accepting new patients
Mental Health Emergency Center, Inc. CurrentSince Sep 7, 2022 Accepting new patients
Aurora Health Care Metro, Inc. Past Accepting new patients

Locations

5900 S Lake Dr
Cudahy, WI 53110
Phone (414) 489-4055

2305 San Luis Pl
Green Bay, WI 54304
Phone (920) 494-2817

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

2200 E Kenwood Blvd
Milwaukee, WI 53211
Phone (414) 229-4627

1525 N 12th St
Milwaukee, WI 53205
Phone (414) 966-3030

855 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 451-5643

2424 S 90th St
West Allis, WI 53227
Phone (414) 321-2255

Organizations & group practices 4

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 2

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722124800000",
    "number": "1700993136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 S 90TH ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272455",
            "telephone_number": "414-773-4312"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5900 S Lake Dr",
            "address_purpose": "LOCATION",
            "city": "Cudahy",
            "state": "WI",
            "postal_code": "531103171",
            "country_code": "US",
            "telephone_number": "414-489-4125",
            "fax_number": "414-489-4056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYLAVARAPU",
        "first_name": "SRIKRISHNA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2024-07-28",
        "certification_date": "2024-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "40767",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "44856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33349600",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smylavarapu9624@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5900 S Lake Dr",
            "city": "Cudahy",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531103171",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "5900 S Lake Dr",
            "city": "Cudahy",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531103171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

Verify at the official NPI Registry.