Active NPI
Sanjay Konakondla, M.D.
- Neurological Surgery Physician
- Danville, PA
National Provider Identifier
1851652549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- MD467792
- Practice address
- 100 N Academy Ave
Danville, PA 17822-9800 - Phone
- (570) 271-6437
- Fax
- (570) 271-6663
- NPI assigned
- May 30, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | 2012015810 | MO | |
| Neurological Surgery Physician | 207T00000X | MD16092 | RI | |
| Neurological Surgery Physician | 207T00000X | MD467792 | PA | Primary |
Addresses
Primary practice location
100 N Academy Ave
Danville, PA 17822-9800
Mailing address
100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2012015810 | Other | MO | MISSOURI LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | skonakondla124185@direct.geisinger.edu | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective May 1, 2025 through May 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2012015810 | MO | MD | Neurological Surgery Physician |
| MD16092 | RI | MD | Neurological Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients |
Interoperability endpoints
- skonakondla124185@direct.geisinger.edu
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598832000000",
"number": "1851652549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 N ACADEMY AVE",
"city": "DANVILLE",
"state": "PA",
"postal_code": "178224903",
"telephone_number": "570-271-6144",
"fax_number": "570-271-6578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 N ACADEMY AVE",
"city": "DANVILLE",
"state": "PA",
"postal_code": "178229800",
"telephone_number": "570-271-6437",
"fax_number": "570-271-6663"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KONAKONDLA",
"first_name": "SANJAY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-05-30",
"last_updated": "2020-08-31",
"certification_date": "2020-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "MO",
"license": "2012015810",
"primary": false
},
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "RI",
"license": "MD16092",
"primary": false
},
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "PA",
"license": "MD467792",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MISSOURI LICENSE",
"identifier": "2012015810",
"state": "MO"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "skonakondla124185@direct.geisinger.edu",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "100 N Academy Ave",
"city": "Danville",
"state": "PA",
"country_code": "US",
"postal_code": "178229800",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Danville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.