Sreenivasulu Bogachenchu, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2016010622 Issued in MO

Practice address

1400 US Highway 61
Festus, MO 63028-4100

Phone

(636) 933-5337

NPI assigned

May 12, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Internal MedicineAlso: Hospitalist

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Anthonys Physician Organization Hospitalist Services LCGroup PAC ID 5092980656, 140 clinicians

Mercy Clinic Adult Hospitalists Jefferson LLCGroup PAC ID 8628205598, 58 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Jefferson Hospital, Crystal City, MO, CCN 260023
• Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077
• Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Mercy Clinic Adult Hospitalists- Jefferson, LLC

  • Internal Medicine Physician
  • Festus, MO
  • NPI 1083052492
  Medicare reassignment Care Compare group NPD
• St Anthonys Physician Organization Hospitalist Services, L.C.

  • Hospitalist Physician
  • Saint Louis, MO
  • NPI 1407216336
  Medicare reassignment Care Compare group NPD
• Mercy Clinic Adult Hospitalists - St. Louis, LLC

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1841235108
  Medicare reassignment NPD
• Mercy Clinic Adult Hospitalists - Washington, LLC

  • Hospitalist Physician
  • Washington, MO
  • NPI 1891943429
  Medicare reassignment NPD
• Mercy Clinic Hyperbaric and Wound Care LLC

  • Surgery Physician
  • Festus, MO
  • NPI 1336568864
  Medicare reassignment NPD
• Mercy Hospital Lincoln

  • Critical Access Hospital
  • Troy, MO
  • NPI 1962808733

  Internal Medicine

  Medicare reassignment NPD
• Mercy Hospital Jefferson

  • General Acute Care Hospital
  • Festus, MO
  • NPI 1508859661
  NPD (past)
• Mercy Hospital South

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1568481984
  NPD (past)
• Cogent Healthcare of Illinois, LLC

  • Internal Medicine Physician
  • Quincy, IL
  • NPI 1487897849
  NPD (past)

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

• Mercy Hospital Jefferson

  • General Acute Care Hospital
  • Festus, MO
  • NPI 1508859661
  Care Compare affiliation
• Mercy Hospital South

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1568481984
  Care Compare affiliation
• Mercy Hospitals East Communities

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1427098169
  Care Compare affiliation
• Mercy Hospitals East Communities

  • Land Ambulance
  • Saint Louis, MO
  • NPI 1881329902

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1273622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1831417070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 US HIGHWAY 61",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284100",
            "telephone_number": "636-933-5337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 US HIGHWAY 61",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284100",
            "telephone_number": "636-933-5337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10010 Kennerly Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631282106",
            "country_code": "US",
            "telephone_number": "314-525-1328",
            "fax_number": "314-525-1378",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOGACHENCHU",
        "first_name": "SREENIVASULU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-12",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036125603",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036125603",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2016010622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TBD",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adrienne Michelle Birge
• Courtney Bishop, LCPC
• Shelly Blankenship, MS,OTR/L
• Shannon Leigh Blum, ATC, PTA
• Julie A Boardman
• Brittany Bohn
• Miriam Bohnert, LCSW
• Joshua Paul Boldt, MD
• Wendy Boley, LCSW
• Jessica Marie Booker, PMHNP

• Internal Medicine Physician in Festus, MO
• Providers in Festus, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2022; 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.