Individual provider Active NPI

Srijaya Soujanya Nalla, M.D.

  • Obstetrics & Gynecology Physician
  • Drexel Hill, PA
National Provider Identifier
1932432580
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
DR.0056318 Issued in CO
Practice address
2100 Keystone Ave
Suite 206
Drexel Hill, PA 19026-1129
Phone
(610) 394-4710
Fax
(610) 394-4721
NPI assigned
Sep 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MT194769 PA
Obstetrics & Gynecology Physician 207V00000X MD449133 PA
Obstetrics & Gynecology Physician 207V00000X DR.0056318 CO Primary

Addresses

Primary practice location

2100 Keystone Ave
Suite 206
Drexel Hill, PA 19026-1129

Mailing address

PO Box 800022
Kansas City, MO 64180-3182
Phone (800) 953-0104

Other practice location 1

2030 Mountain View Ave Ste 400
Longmont, CO 80501-3182
Phone (720) 652-8730

Other identifiers 1

IdentifierTypeStateIssuer
23370050MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20160324000719 CO Practitioner - Obstetrics/Gynecology 0446492961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

2030 Mountain View Ave
Suite 400
Longmont, CO 80501-3182
Phone (720) 652-8730

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.06 of 100Reported as group
Quality
89.53
Promoting interoperability
100
Improvement activities
40
Cost
74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DR.0056318COMDObstetrics & Gynecology Physician
MT194769PAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado CurrentSince Nov 15, 2021 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Nov 15, 2021 Accepting new patients
Catholic Health Initiatives Colorado Current Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients
Longmont United Hospital Past Accepting new patients

Locations

2030 Mountain View Ave
Ste 400
Longmont, CO 80501
Phone (303) 776-1532

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1252972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1932432580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 800022",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641803182",
            "telephone_number": "800-953-0104",
            "fax_number": "303-765-6670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 KEYSTONE AVE",
            "address_2": "SUITE 206",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190261129",
            "telephone_number": "610-394-4710",
            "fax_number": "610-394-4721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2030 Mountain View Ave Ste 400",
            "address_purpose": "LOCATION",
            "city": "Longmont",
            "state": "CO",
            "postal_code": "805013182",
            "country_code": "US",
            "telephone_number": "720-652-8730",
            "fax_number": "720-652-8729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NALLA",
        "first_name": "SRIJAYA SOUJANYA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-15",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MT194769",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MD449133",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CO",
            "license": "DR.0056318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "23370050",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Drexel Hill, PA

Sources for this page

Verify at the official NPI Registry.