Individual provider Active NPI

Srinivas Kottapally, M.D.

  • Radiation Oncology Physician
  • Uniontown, PA
National Provider Identifier
1962404343
Registry record updated Dec 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
MD039369L Issued in PA
Practice address
51 Brewer Dr
Uniontown, PA 15401-8400
Phone
(724) 437-2503
Fax
(724) 437-8846
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X MD039369L PA Primary

Addresses

Primary practice location

51 Brewer Dr
Uniontown, PA 15401-8400

Mailing address

845 Ashton CT
North Huntingdon, PA 15642-3999
Phone (814) 603-3676

Other identifiers 1

IdentifierTypeStateIssuer
470927OtherPAHIGHMARK BC/BS

Other names 1

  • Sri Kottapally Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20040210000445 PA Practitioner - Radiation Oncology 2567356710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fayette Oncology AssociatesGroup PAC ID 1052201589, 5 clinicians

Practice addresses (Care Compare)

51 Brewer Dr
Uniontown, PA 15401-8400
Phone (724) 437-2503

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD039369LPAMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fayette Oncology Associates Radiation Oncology CurrentSince Aug 1, 2012 Accepting new patients

Locations

51 Brewer Dr
Uniontown, PA 15401
Phone (724) 437-2503

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.

Hospital & facility affiliations 5

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": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386720000000",
    "number": "1962404343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 ASHTON CT",
            "city": "NORTH HUNTINGDON",
            "state": "PA",
            "postal_code": "156423999",
            "telephone_number": "814-603-3676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 BREWER DR",
            "city": "UNIONTOWN",
            "state": "PA",
            "postal_code": "154018400",
            "telephone_number": "724-437-2503",
            "fax_number": "724-437-8846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTTAPALLY",
        "first_name": "SRINIVAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2013-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "PA",
            "license": "MD039369L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BC/BS",
            "identifier": "470927",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SRI",
            "last_name": "KOTTAPALLY",
            "credential": "M.D",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Uniontown, PA

Sources for this page

Verify at the official NPI Registry.