Sirish Kumar Kondabolu

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

MD465257 Issued in PA

Practice address

912 Russell Dr
Lebanon, PA 17042

Phone

(717) 272-7971

Fax

(717) 272-1241

NPI assigned

Apr 11, 2012

Last updated

Jan 18, 2019By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547769600000",
    "number": "1821354176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 CONCORD RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174029001",
            "telephone_number": "717-851-1405",
            "fax_number": "717-851-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 RUSSELL DR",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "17042",
            "telephone_number": "717-272-7971",
            "fax_number": "717-272-1241"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Stony Brook University Medical Center",
            "address_2": "Department of Orthopaedics, HSC T-18",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "117948181",
            "country_code": "US",
            "telephone_number": "631-444-1487",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Stony Brook University Medical Center",
            "address_2": "Department of Orthopaedics, HSC T-18",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "117948181",
            "country_code": "US",
            "telephone_number": "631-444-1487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KONDABOLU",
        "first_name": "SIRISH",
        "middle_name": "KUMAR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-11",
        "last_updated": "2019-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "275452",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "MD465257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas D Kohl, MD
• Samuel Kolman, MD
• Irina Kolos, M.D.
• Donald Gary Kolva, M.D.
• Amber Gwen Komykoski, CRNA
• Kevin A Koons, PHARM.D.
• Richard Kenton Koons, D C
• Kathleen Kopecky-Groh, DMD
• Christopher G Korba, PT, ATC
• Michelle Lynn Korczynski

• Orthopaedic Surgery Physician in Lebanon, PA
• Providers in Lebanon, PA by specialty
• Orthopaedic Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2019; 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.