DR. SRINIVAS RAO MANDAVILLI (NPI# 1255312492) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255312492 |
| Entity Type | Individual |
| Full Name | DR. SRINIVAS RAO MANDAVILLI |
| Credential | M.D. |
| Practice Address |
111 Founders Plz #300 C/o Ipms East Hartford CT 06108-3212 |
| Practice Telephone | 8602824137 |
| Practice Fax Number | 8602820170 |
| Mailing Telephone | 8602824137 |
| Mailing Fax Number | 8602820170 |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
036761 | CT | Allopathic & Osteopathic Physicians |
| Street Address |
111 FOUNDERS PLZ #300 C/O IPMS |
| City | EAST HARTFORD |
| State | CT |
| Zip Code | 06108-3212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083612451 | Nancy J Weinstein | Anesthesiology | 111 Founders Plz, #300, East Hartford, CT 06108-3212 | 2005-07-11 |
| 1912290883 | Timothy J Herbst | Radiology | 111 Founders Plz, Suite 400, East Hartford, CT 06108-3212 | 2011-05-25 |
| 1659514628 | Barbara Arcarese | Pathology | 111 Founders Plz, Suite 300, East Hartford, CT 06108-3212 | 2009-04-07 |
| 1164672192 | Jocelyn M Depathy | Physician Assistant | 111 Founders Plz, Ste 400, East Hartford, CT 06108-3212 | 2008-09-26 |
| 1487838991 | Donna M Sanchez | Nurse Anesthetist, Certified Registered | 111 Founders Plz, Suite 300, East Hartford, CT 06108-3212 | 2007-12-19 |
| 1508989435 | Mark George Indelicato | Anesthesiology | 111 Founders Plz, Suite 300, East Hartford, CT 06108-3212 | 2007-04-07 |
| 1730216052 | Lucy A Davidson | Nurse Anesthetist, Certified Registered | 111 Founders Plz, Suite 300 Attn Credentialing, East Hartford, CT 06108-3212 | 2007-02-27 |
| 1609919869 | Carol Curland | Nurse Anesthetist, Certified Registered | 111 Founders Plz, Suite 300, East Hartford, CT 06108-3212 | 2007-02-15 |
| 1700949831 | Care Focus, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 111 Founders Plz, Suite 103, East Hartford, CT 06108-3212 | 2006-12-19 |
| 1134203284 | Beacon Hospice, LLC | Hospice Care, Community Based | 111 Founders Plz, Suite 1803, East Hartford, CT 06108-3212 | 2006-10-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003437435 | Decent Homecare Services LLC | Homemaker | 527 Burnside Avenue, Suite 1, East Hartford, CT 06108 | 2020-04-27 |
| 1164055810 | First Choice Health Center Inc | Durable Medical Equipment & Medical Supplies | 110 Connecticut Blbd, East Hartford, CT 06108 | 2020-02-20 |
| 1457848731 | Heavenly Care LLC | Home Health | 35 Greene Terrace, East Hartford, CT 06108 | 2018-04-22 |
| 1750894275 | Thamara Vanessa Jonathas | Nurse Practitioner | 477 Connecticut Blvd Ste 119, East Hartford, CT 06108 | 2017-11-06 |
| 1851802474 | Empathic Care Counseling LLC | Counselor | 357 East Center Street, Manchester, CT 06108 | 2017-10-23 |
| 1235654427 | Kacey Megquier | Specialist/Technologist | 132 Arbutus Street, East Hartford, CT 06108 | 2017-08-08 |
| 1225559826 | First Choice Health Centers, Inc. | Clinic/Center | 809 Main Street, East Hartford, CT 06108 | 2017-07-05 |
| 1205361599 | Freda Osei-parker | Pharmacist | 16a Saint Regis Street, East Hartford, CT 06108 | 2017-04-25 |
| 1831648740 | Marcia Loving Care Home Care Agency | Home Health | 23 Bidwell Street, East Hartford, CT 06108 | 2016-10-04 |
| 1770932642 | First Choice Health Centers, Inc. | Clinic/Center | 92 Connecticut Boulevard, East Hartford, CT 06108 | 2016-06-10 |
| Find all providers in zip 06108 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437130242 | Mark Edward Ludwig | Pathology | 111 Founders Plz, #300 C/o Ipms, East Hartford, CT 06108-3212 | 2005-11-09 |
| 1982685129 | Yanjun Su | Pathology | 111 Founders Plz, #300 C/o Ipms, East Hartford, CT 06108-3212 | 2005-11-07 |
| 1710968961 | Mary Desiree Fiel-gan | Pathology | 99 E River Dr, 5th Floor, East Hartford, CT 06108-3288 | 2005-11-07 |
| 1417948712 | Bela S Mandavilli | Pathology | 111 Founders Plz, #300 C/o Ipms, East Hartford, CT 06108-3212 | 2005-11-04 |
| 1972591477 | Thomas Edward Ciesielski | Pathology | 111 Founders Plz, #300 C/o Ipms, East Hartford, CT 06108-3212 | 2005-10-10 |
| 1710975230 | Vijay V Joshi | Pathology | 111 Founders Plz, #300 C/o Ipms, East Hartford, CT 06108-3212 | 2005-10-10 |
| 1629065271 | Richard Muller | Pathology | 111 Founders Plz, #300 C/o Ipms, East Hartford, CT 06108-3212 | 2005-09-29 |
| 1730174103 | Matthew James Curran | Pathology | 99 E River Dr, C/o Ipms, East Hartford, CT 06108 | 2005-09-13 |
| 1104819382 | Joseph Arthur Digiuseppe | Pathology | 111 Founders Plz, #300 C/o Ipms, East Hartford, CT 06108-3212 | 2005-08-24 |
| 1124027875 | Desiderio G. Arce | Pathology | 111 Founders Plz, #300 C/o Ipms, East Hartford, CT 06108-3212 | 2005-07-15 |
| Find all providers in EAST HARTFORD | ||||
| City | EAST HARTFORD |
| Zip Code | 06108 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.