Srichand Sadhuram Dara, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

8228 Issued in NM

Practice address

110 South Halagueno St
Suite 6
Carlsbad, NM 88220

Phone

(505) 887-6556

Fax

(505) 234-1206

NPI assigned

Sep 14, 2006

Last updated

Jul 8, 2007By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM

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

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730284548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 SOUTH HALAGUENO ST",
            "address_2": "SUITE 6",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "88220",
            "telephone_number": "505-887-6556",
            "fax_number": "505-234-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 SOUTH HALAGUENO ST",
            "address_2": "SUITE 6",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "88220",
            "telephone_number": "505-887-6556",
            "fax_number": "505-234-1206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARA",
        "first_name": "SRICHAND",
        "middle_name": "SADHURAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "8228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39800",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teresa Cunningham
• CVS Pharmacy Inc (CVS Pharmacy #10448)
• Cyfd-State of New Mexico-Carlsbad CRF (Carlsbad CRF)
• Marcin Wilhelm Czerniakow, MD
• Nels N Dahlgren, MD
• Daves Health Services, LLC
• Michelle Davis-Wright
• Bruna F. De Gouveia, DDS
• Alexander M De la Rosa
• Joshua De Los Santos

• Pediatrics Physician in Carlsbad, NM
• Providers in Carlsbad, NM by specialty
• Pediatrics Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.