Organization Active NPI

Jayaselvi Kolli MD PC

  • Obstetrics & Gynecology Physician
  • Niagara Falls, NY
National Provider Identifier
1982630133
Registry record updated Nov 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
JAYASELVI KOLLI MD PC
Practice address
6934 Elaine Drive
Niagara Falls, NY 14304
Phone
(716) 278-9619
Fax
(716) 213-0935
NPI assigned
Jun 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2007

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

Authorized official

Name
Dr. Jayaselvi Kolli, MDNPI 1548239726
Title
Owner
Phone
(716) 278-9619

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

6934 Elaine Drive
Niagara Falls, NY 14304

Mailing address

908 Niagara Falls Blvd
Suite 208
North Tonawanda, NY 14120-2019
Phone (716) 692-2160

Other identifiers 1

IdentifierTypeStateIssuer
02730918MedicaidNY

Other names 1

  • Aum OB Gyn Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060222000357 NY Part B Supplier - Clinic/Group Practice 1456367853 Receives reassigned benefits from 2 practitioners
Practice locations: Niagara Falls, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D1018923Jayaselvi Kolli MD PC6934 Elaine Drive, Niagara Falls, NY 14304Provider-performed microscopyNov 4, 2027

National Provider Directory

National Provider Directory

Locations

621 10th St
#304
Niagara Falls, NY 14301
Phone (716) 278-9619

6934 Elaine Dr
Niagara Falls, NY 14304
Phone (716) 278-9619

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195516800000",
    "number": "1982630133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 NIAGARA FALLS BLVD",
            "address_2": "SUITE 208",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141202019",
            "telephone_number": "716-692-2160",
            "fax_number": "716-213-0935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6934 ELAINE DRIVE",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "14304",
            "telephone_number": "716-278-9619",
            "fax_number": "716-213-0935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAYASELVI KOLLI MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2007-11-20",
        "status": "A",
        "authorized_official_last_name": "KOLLI",
        "authorized_official_first_name": "JAYASELVI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "716-278-9619",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02730918",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aum OB Gyn Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Niagara Falls, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.