Individual provider Active NPI

Srikanth Nadella, M.D.

  • Internal Medicine Physician
  • Maryville, IL
National Provider Identifier
1740599109
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2010033328 Issued in MO
Practice address
2133 Vadalabene Dr Ste 1
Maryville, IL 62062-5839
Phone
(618) 288-4350
Fax
(618) 288-4296
NPI assigned
Oct 4, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2010033328 MO Primary

Addresses

Primary practice location

2133 Vadalabene Dr Ste 1
Maryville, IL 62062-5839

Mailing address

6810 State Route 162
Box 215
Maryville, IL 62062
Phone (618) 391-6495

Other practice location 1

10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 346-5659

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131217001298 MO Practitioner - Internal MedicinePractitioner - Hospitalist 9537396635 Reassigns benefits to 4 organizations
I20220907001768 IL Practitioner - Internal Medicine 9537396635 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Physician Services PCGroup PAC ID 0042307852, 591 clinicians
Anderson Medical Group LLCGroup PAC ID 5193792018, 136 clinicians

Practice addresses (Care Compare)

10 Hospital Dr
Saint Peters, MO 63376-1659
Phone (800) 501-9855

2133 Vadalabene Dr
Suite 1
Maryville, IL 62062-5839
Phone (618) 288-4350

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.76 of 100Reported as group
Quality
54.98
Promoting interoperability
85
Improvement activities
40
Cost
73.39

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2010033328MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anderson Medical Group, LLC Internal Medicine CurrentSince Oct 1, 2022 Accepting new patients
Sound Physicians of Illinois, LLC Internal Medicine CurrentSince Jun 1, 2021 Accepting new patients
Galen Inpatient Physicians PC CurrentSince Nov 1, 2020 Accepting new patients
Southeastern Physician Services PC Internal Medicine CurrentSince Jul 1, 2016 Accepting new patients
Cogent Healthcare of Missouri, Inc CurrentSince Jan 1, 2022 Accepting new patients
Galen Inpatient Physicians PC. Internal Medicine CurrentSince Nov 1, 2020 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

6810 State Route 162
Ste 215
Maryville, IL 62062
Phone (618) 391-6405

2133 Vadalabene Dr
Ste 1
Maryville, IL 62062
Phone (618) 288-4350

12303 De Paul Dr
Bridgeton, MO 63044
Phone (314) 344-6360

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

100 Medical Plz
Lake St Louis, MO 63367
Phone (636) 625-5200

300 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 669-2211

6420 Clayton Rd
Saint Louis, MO 63117
Phone (314) 768-8442

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

11133 Dunn Rd
#2427
Saint Louis, MO 63136
Phone (314) 653-5643

10 Hospital Dr
Saint Peters, MO 63376
Phone (636) 394-2522

232 S Woods Mill Rd
Town and Country, MO 63017
Phone (314) 205-6030

Organizations & group practices 6

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 6

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": "1286150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1740599109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6810 STATE ROUTE 162",
            "address_2": "BOX 215",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "62062",
            "telephone_number": "618-391-6495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2133 VADALABENE DR STE 1",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625839",
            "telephone_number": "618-288-4350",
            "fax_number": "618-288-4296"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10010 Kennerly Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631282106",
            "country_code": "US",
            "telephone_number": "314-346-5659",
            "fax_number": "314-525-1328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NADELLA",
        "first_name": "SRIKANTH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-04",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2010033328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, IL

Sources for this page

Verify at the official NPI Registry.