Satyanarayana M Mamidi, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

35-045590 Issued in OH

Practice address

1300 Clark St Unit 7
Cambridge, OH 43725-8875

Phone

(740) 439-5107

Fax

(740) 439-5183

NPI assigned

Jul 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Genesis Medical Group LLC

  • General Practice Physician
  • Zanesville, OH
  • NPI 1063663433

  Cardiovascular Disease

  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294358400000",
    "number": "1790710218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 CLARK ST UNIT 7",
            "city": "CAMBRIDGE",
            "state": "OH",
            "postal_code": "437258875",
            "telephone_number": "740-439-5107",
            "fax_number": "740-439-5183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 CLARK ST UNIT 7",
            "city": "CAMBRIDGE",
            "state": "OH",
            "postal_code": "437258875",
            "telephone_number": "740-439-5107",
            "fax_number": "740-439-5183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMIDI",
        "first_name": "SATYANARAYANA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2011-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WV",
            "license": "12853",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35-045590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOUNTAINSTATE BLUECROSS B",
            "identifier": "001705987",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0517435",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "11-3703997",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA3951",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "113703997 0004",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yetta D. Lynn
• Eyad Mahayri, M.D.
• Baidehi Maiti, M.D., PH.D.
• Malachi'S Grove Counseling LLC
• Addie E Mallett
• Jennifer Mann, LCDC II, OCPSI
• Jolinda M Markel, RN
• Sarah M Marks, QMHS
• Constance A Marling
• Michael John Paul Marston, ATC

• All providers in Cambridge, OH
• Cardiovascular Disease Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.