Sravani Kamatam, M.D

Key facts

NPI

1962885095

Entity type

Individual (NPI type 1)

Primary specialty

Internal Medicine Physician 207R00000X

License

036145430 (IL)

Practice address

530 NE Glen Oak Ave
Peoria, IL 61637-0001

Phone

(309) 624-8818

Fax

(309) 624-8820

NPI assigned

Jul 7, 2015

Sex

Female

Sole proprietor

Yes

Organizations & group practices 2

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.

• Osf Multi-Specialty Group Internal Medicine Physician · Peoria, IL · NPI 1922445527
  Medicare reassignment Care Compare group NPD IL · SINGLE SPECIALTY
• Central PA Pharmacy LLC. Community/Retail Pharmacy · Patton, PA · NPI 1578541413
  NPD SINGLE SPECIALTY

Hospital & facility affiliations 1

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

• St Mary Medical Center General Acute Care Hospital · Galesburg, IL · NPI 1164485363
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Hospitalist

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Osf Multi-Specialty Group (2,123 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Francis Medical Center Hospital · Peoria, IL · CCN 140067
• St Mary Medical Center Hospital · Galesburg, IL · CCN 140064

Medicare participation

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 31, 2018.

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535673600000",
    "number": "1962885095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001",
            "telephone_number": "309-624-8818",
            "fax_number": "309-624-8820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001",
            "telephone_number": "309-624-8818",
            "fax_number": "309-624-8820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2351 E 22nd St",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441153111",
            "country_code": "US",
            "telephone_number": "216-861-6200",
            "fax_number": "216-363-7490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAMATAM",
        "first_name": "SRAVANI",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-07",
        "last_updated": "2018-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "57.025775",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036145430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nikhil Reddy Kalva, M.D
• Kavitha Kalvakuri, M.D.
• Zainab Anwar Kamdi
• Timothy Kampert
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• Bhavana Thota Kandikattu, MD
• Manasa Kandula

All providers in Peoria, IL · Internal Medicine Physician in Illinois