NPIMap

Individual provider Active NPI

Sita L Yanamadala, M.D.

  • Nephrology Physician
  • Lynwood, CA
National Provider Identifier
1821049255
Registry record updated Nov 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A49746 Issued in CA
Practice address
3625 Martin Luther King Jr Blvd
Suite #2
Lynwood, CA 90262-3509
Phone
(310) 638-0533
Fax
(310) 638-9171
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A49746 CA Primary

Addresses

Primary practice location

3625 Martin Luther King Jr Blvd
Suite #2
Lynwood, CA 90262-3509

Mailing address

3625 Martin Luther King Jr Blvd
Suite #2
Lynwood, CA 90262-3509
Phone (310) 638-0533

Other identifiers 1

IdentifierTypeStateIssuer
GR0067120MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100811000203 CA Practitioner - Internal MedicinePractitioner - Nephrology 5698802171 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles (6 of 7)

OrganizationSpecialtyStatusNew patients
Long Beach Memorial Medical Past Accepting new patients
St Francis Medical Center Past Accepting new patients
Greater Long Beach Vascular Access, a Medical Corporation Nephrology PastSince Mar 15, 2010 Accepting new patients
University of California Irvine Past Accepting new patients
Coast Plaza Doctors Hospital Past Accepting new patients
Los Alamitos Medical Center, Inc. Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renal Medical Associates 3 clinicians

Practice addresses (Care Compare)

3625 Martin Luther King Jr Blvd
Suite 2
Lynwood, CA 90262-3509
Phone (310) 638-0533

Hospital & facility affiliations

  • DaVita Imperial Care Dialysis Center Dialysis facility, Lynwood, CA, CCN 052844
  • DaVita Premier Dialysis Center Dialysis facility, Cudahy, CA, CCN 052761
  • DaVita Kidney Dialysis Care Unit Dialysis facility, Lynwood, CA, CCN 052502
  • DaVita Firestone Blvd Dialysis Dialysis facility, Norwalk, CA, CCN 552727
  • Saint Francis Medical Center Hospital, Lynwood, CA, CCN 050104

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257292800000",
    "number": "1821049255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3625 MARTIN LUTHER KING JR BLVD",
            "address_2": "SUITE #2",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902623509",
            "telephone_number": "310-638-0533",
            "fax_number": "310-638-9171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 MARTIN LUTHER KING JR BLVD",
            "address_2": "SUITE #2",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902623509",
            "telephone_number": "310-638-0533",
            "fax_number": "310-638-9171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANAMADALA",
        "first_name": "SITA",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2009-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A49746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0067120",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynwood, CA

Sources for this page

Verify at the official NPI Registry.