Active NPI
Sailaja Damineni, M.D.
- Family Medicine Physician
- St. Albans, NY
National Provider Identifier
1992718209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 238217
- Practice address
- 111-20 Merrick Blvd
St. Albans, NY 11433 - Phone
- (718) 206-9888
- Fax
- (718) 206-3033
- NPI assigned
- Aug 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 238217 | NY | Primary |
Addresses
Primary practice location
111-20 Merrick Blvd
St. Albans, NY 11433
Mailing address
80 Marcus Drive
Provider Enrollment
Melville, NY 11747
Phone (631) 391-7700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260513002143 | NY | Order and Referring Only - Family Practice | 2062416589 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992718209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 MARCUS DRIVE",
"address_2": "PROVIDER ENROLLMENT",
"city": "MELVILLE",
"state": "NY",
"postal_code": "11747",
"telephone_number": "631-391-7700",
"fax_number": "631-454-4161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111-20 MERRICK BLVD",
"city": "ST. ALBANS",
"state": "NY",
"postal_code": "11433",
"telephone_number": "718-206-9888",
"fax_number": "718-206-3033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAMINENI",
"first_name": "SAILAJA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "238217",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St. Albans, NY
Sources for this page
- 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.