Sridevi Panchamukhi, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

036-101393 Issued in IL

Practice address

9925 Gillespie Dr Ste 2400
Plano, TX 75025-1099

Phone

(972) 905-1550

Fax

(855) 592-0913

NPI assigned

Jul 14, 2005

Reactivated

May 1, 2006

Sex

Female

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 8

Other names 1

• Sridevi Pydikondala Former name

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Obstetrics/Gynecology

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EBCCDD/Endpoint/EBCCDD

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.

• SP OBGYN ,PLLC

  • Obstetrics & Gynecology Physician
  • Plano, TX
  • NPI 1659056968
  Medicare reassignment NPD Authorized official
• Obhg Texas Holdings, P.a.

  • Obstetrics & Gynecology Physician
  • Austin, TX
  • NPI 1083917769
  Medicare reassignment NPD
• Rural Health, Inc

  • Rural Health Clinic/Center
  • Herrin, IL
  • NPI 1326102716
  NPD (past)
• Rural Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Dongola, IL
  • NPI 1366506628
  NPD (past)
• Rural Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Vienna, IL
  • NPI 1932263332
  NPD (past)

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1831197656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6863 ELDARICA PL",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750348352",
            "telephone_number": "469-325-1093",
            "fax_number": "855-592-0913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9925 GILLESPIE DR STE 2400",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750251099",
            "telephone_number": "972-905-1550",
            "fax_number": "855-592-0913"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5140 Legendary Dr",
            "address_purpose": "LOCATION",
            "city": "Frisco",
            "state": "TX",
            "postal_code": "750349042",
            "country_code": "US",
            "telephone_number": "469-325-1093",
            "fax_number": "855-592-0913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANCHAMUKHI",
        "first_name": "SRIDEVI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-14",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "deactivation_date": "2006-03-31",
        "reactivation_date": "2006-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "R7081",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036-101393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPVA",
            "identifier": "H12137",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE RR MEDI",
            "identifier": "H12137",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "H12137",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "055761",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "422714",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-101393",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDPA FEE FOR SERVICE",
            "identifier": "036101393",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "H12137",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SRIDEVI",
            "last_name": "PYDIKONDALA",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Pamela Moore, MD, PA
• Pamela Roos LCSW PLLC
• Anca Pamfil, MD
• Kurt X Pan
• Erwin Vincent Bernales Panaligan, PT
• Vasanti G Pancholy, MD
• Hemang Kirteekumar Pandya, M.D.
• Tanvi Pandya
• Albert Waikeung Pang, OD
• Shefali Pangasa

• Obstetrics & Gynecology Physician in Plano, TX
• Providers in Plano, TX by specialty
• Obstetrics & Gynecology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; 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.

Verify at the official NPI Registry.