Srinivas S Chetty, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

43396 Issued in WI

Practice address

1020 Lakeshore Dr
Rice Lake, WI 54868

Phone

(715) 236-8118

NPI assigned

Aug 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Marshfield Clinic Inc

  • Clinic/Center
  • Marshfield, WI
  • NPI 1952347981
  NPD

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982711255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 LAKESHORE DR",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "54868",
            "telephone_number": "715-236-8118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHETTY",
        "first_name": "SRINIVAS",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "43396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34095400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kay Loree Case, PA-C
• Cedarcrest Surgery Center LLC
• Cedarcrest Surgery Center LLC
• Cek Family Companion Care
• Charles Kent Meng O D LTD
• Chippewa Valley Orthopedics and Sports Medicine Clinic, SC
• Vidya Sagar Reddy Cirra, MD
• City of Rice Lake
• Ashley Clark, RN
• Clear Path Clinic SC

• Internal Medicine Physician in Rice Lake, WI
• Providers in Rice Lake, WI by specialty
• Internal Medicine Physician in Wisconsin

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.