Sudhakar Madakasira

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

12701 Issued in MS

Practice address

2540 Flowood Dr
Ste a
Flowood, MS 39232-9362

Phone

(601) 664-1001

NPI assigned

Sep 28, 2006

Sex

Male

Sole proprietor

Yes

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2017 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891886339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2540 FLOWOOD DR",
            "address_2": "STE A",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329362",
            "telephone_number": "601-664-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2540 FLOWOOD DR",
            "address_2": "STE A",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329362",
            "telephone_number": "601-664-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADAKASIRA",
        "first_name": "SUDHAKAR",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MS",
            "license": "12701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayleigh McEwen Lyons, FNP-C
• M H Allen LLC
• M-D Medical Services, Inc.
• Anna Kristen Macdonald, PT, DPT
• Amy Macon, P.T.
• John B Madden, M.D.
• Madison Physician Surgery Center, LLC
• Magnolia Anesthesia Consultants LLC
• Magnolia Elite Wellness Group LLC
• Magnolia Internal Medical Clinic

• All providers in Flowood, MS
• Psychiatry Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.