Individual provider Active NPI

Sri J Obulareddy, M.D.

  • Medical Oncology Physician
  • Yakima, WA
National Provider Identifier
1760779979
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
E-15874 Issued in AR
Practice address
808 N 39TH Ave
Yakima, WA 98902-6388
Phone
(509) 574-3400
Fax
(509) 574-3464
NPI assigned
Jul 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X 13992 ND
Internal Medicine Physician 207R00000X E-15874 AR
Medical Oncology Physician 207RX0202X BP20049352 TX
Medical Oncology Physician 207RX0202X MD60793231 WA
Medical Oncology Physician 207RX0202X E-15874 AR Primary

Addresses

Primary practice location

808 N 39TH Ave
Yakima, WA 98902-6388

Mailing address

4301 W Markham St # 783
Little Rock, AR 72205-7101
Phone (501) 686-8000

Other practice location 1

4301 W Markham St # 508
Little Rock, AR 72205
Phone (501) 686-8530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20230105002880 AR Practitioner - Medical OncologyPractitioner - Internal Medicine 7618262254 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Medical OncologyAlso: Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4301 W Markam St
Little Rock, AR 72205-7101
Phone (501) 686-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP20049352TXMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Oncology CurrentSince Apr 3, 2023 Accepting new patients
Baptist Health Medical Oncology CurrentSince Apr 3, 2023 Accepting new patients
Baptist Health Current Accepting new patients
University of Arkansas for Medical Sciences Family Medicine CurrentSince Jan 1, 2023 Accepting new patients
University of Arkansas for Medical Sciences Family Medicine Current Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jan 1, 2023 Accepting new patients

Locations

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

4301 W Markham St
#508
Little Rock, AR 72205
Phone (501) 686-8511

9500 Kanis Rd
Ste 500
Little Rock, AR 72205
Phone (501) 202-4715

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

104 W Taylor St
Sparkman, AR 71763
Phone (870) 678-2226

Interoperability endpoints

  • Direct secure messaging: sriobulareddy@yvmh.direct.varian.com

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 1

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": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1760779979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 783",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-5148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 N 39TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989026388",
            "telephone_number": "509-574-3400",
            "fax_number": "509-574-3464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4301 W Markham St # 508",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "72205",
            "country_code": "US",
            "telephone_number": "501-686-8530",
            "fax_number": "501-686-8543",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OBULAREDDY",
        "first_name": "SRI",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-08",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "ND",
            "license": "13992",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-15874",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "TX",
            "license": "BP20049352",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "WA",
            "license": "MD60793231",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "AR",
            "license": "E-15874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.