Active NPI
Surya Theja Polavarapu, MD
- Family Medicine Physician
- Quincy, IL
National Provider Identifier
1780242776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036161586
- Practice address
- 326 N 24TH St
Quincy, IL 62301-3140 - Phone
- (217) 214-6300
- Fax
- (217) 214-6299
- NPI assigned
- Jun 4, 2019
- Last updated
- Sep 24, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 125-074374 | IL | |
| Family Medicine Physician | 207Q00000X | 036161586 | IL | Primary |
Addresses
Primary practice location
326 N 24TH St
Quincy, IL 62301-3140
Mailing address
1005 Broadway St
Quincy, IL 62301-2834
Phone (217) 223-8400
Other practice location 1
612 N 11th St
Quincy, IL 62301-2662
Phone (217) 224-9484
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | spolavarapu24892@blessing.medalliesdirect.net | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4800 Maine St
Quincy, IL 62305-5875
Phone (217) 224-6423
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036161586 | IL | MD | Family Medicine Physician |
| 125-074374 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blessing Hospital | Current | Accepting new patients | |
| Blessing Hospital | Current | Accepting new patients |
Locations
1005 Broadway St
Quincy, IL 62301
326 N 24th St
Quincy, IL 62301
Phone (217) 214-6300
4800 Maine St
Quincy, IL 62305
Phone (217) 214-0444
Interoperability endpoints
- https://fhir.blessinghospital.com/R4/open-Prod
- suryapolavarapu@bcs.allscriptsdirect.net
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- Quincy, IL
- NPI 1114471737
-
dba Blessing Health Monroe City
- Rural Health Clinic/Center
- Monroe City, MO
- NPI 1013683507
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Quincy, IL
- NPI 1548269426
-
- General Acute Care Hospital
- Quincy, IL
- NPI 1760571699
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790208000000",
"number": "1780242776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1005 BROADWAY ST",
"city": "QUINCY",
"state": "IL",
"postal_code": "623012834",
"telephone_number": "217-223-8400",
"fax_number": "217-277-3960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "326 N 24TH ST",
"city": "QUINCY",
"state": "IL",
"postal_code": "623013140",
"telephone_number": "217-214-6300",
"fax_number": "217-214-6299"
}
],
"practiceLocations": [
{
"address_1": "612 N 11th St",
"address_purpose": "LOCATION",
"city": "Quincy",
"state": "IL",
"postal_code": "623012662",
"country_code": "US",
"telephone_number": "217-224-9484",
"fax_number": "217-224-7950",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "POLAVARAPU",
"first_name": "SURYA",
"middle_name": "THEJA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-04",
"last_updated": "2026-09-24",
"certification_date": "2026-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "125-074374",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036161586",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "spolavarapu24892@blessing.medalliesdirect.net",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "326 N 24th St",
"city": "Quincy",
"state": "IL",
"country_code": "US",
"postal_code": "623013140",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Quincy, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.