Sridevi Ellickal, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD-45510 Issued in IA

Practice address

1 Baylor PLZ
Dept of Pediatrics, BCM 320
Houston, TX 77030-3411

Phone

(832) 824-1170

NPI assigned

Apr 23, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

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

Locations

Interoperability endpoints

• Direct secure messaging: sellickal644075@direct.unitypoint.org

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.

• Central Iowa Hospital Corporation

  dba East Des Moines Family Care Center

  • Family Medicine Physician
  • Des Moines, IA
  • NPI 1104879576
  Medicare reassignment NPD
• Trinity Regional Medical Center

  dba UnityPoint Clinic

  • Emergency Medicine Physician
  • Fort Dodge, IA
  • NPI 1073594156
  Medicare reassignment NPD
• Central Iowa Hospital Corporation

  dba IMMC Outpatient Pharmacy

  • Pharmacy
  • Des Moines, IA
  • NPI 1003352949
  NPD
• Central Iowa Hospital Corporation

  dba Blank Health Providers

  • Pediatrics Physician
  • Des Moines, IA
  • NPI 1144309188
  NPD
• St Luke's Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD
• Central Iowa Hospital Corporation

  dba Iowa Methodist Medical Center

  • General Acute Care Hospital
  • Des Moines, IA
  • NPI 1396837951
  NPD (past)
• Central Iowa Hospital Corporation

  dba Iowa Methodist Medical Center-Methodist West

  • General Acute Care Hospital
  • West Des Moines, IA
  • NPI 1598905762
  NPD (past)

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

{
    "created_epoch": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541548800000",
    "number": "1760740195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 PLEASANT STREET",
            "address_2": "SOUTH 2 ROOM 236",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "50301",
            "telephone_number": "515-241-6228",
            "fax_number": "515-241-8685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BAYLOR PLZ",
            "address_2": "DEPT OF PEDIATRICS, BCM 320",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770303411",
            "telephone_number": "832-824-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLICKAL",
        "first_name": "SRIDEVI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-23",
        "last_updated": "2018-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "MD-45510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellery Woo PSYD PLLC
• Patricia C Elles, CRNA
• Jazmine Hillary Elleston, MD
• Elli-Care Health Support
• Jada Mercedes Elliard, MS
• Justine D Elling, NP
• Kariana Ellingsen, LPC-A
• Ellington Field Satellite Clinic
• Roslyn Ellington, FNP
• Lakaesha Andrea Elliott-Reed

• Pediatrics Physician in Houston, TX
• Providers in Houston, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2018; 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.