Sreedhar Reddy Mitta, is a medicare enrolled "Pediatrics" physician in Carthage, Missouri. His current practice location is
2425 Fairlawn Dr, Carthage, Missouri. You can reach out to his office (for appointments etc.) via phone at
(417) 237-0983.
Sreedhar Reddy Mitta is licensed to practice in Missouri (license number 2022030304) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1902455504.
Physician's Profile
Full Name | Sreedhar Reddy Mitta |
---|
Gender | Male |
---|
Speciality | Pediatrics |
---|
Location | 2425 Fairlawn Dr, Carthage, Missouri |
---|
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1902455504
- Provider Enumeration Date: 09/05/2019
- Last Update Date: 08/16/2022
Medicare PECOS Information:
- PECOS PAC ID: 5496085227
- Enrollment ID: I20220818002608
Medical Identifiers
Medical identifiers for Sreedhar Reddy Mitta such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1902455504 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208000000X | Pediatrics | 4351045516 (Michigan) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
208000000X | Pediatrics | 2022030304 (Missouri) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Sreedhar Reddy Mitta allows following entities to bill medicare on his behalf.
Entity Name | Mercy Hospital Carthage |
---|
Entity Type | Part B Supplier - Clinic/group Practice |
---|
Entity Identifiers | NPI Number: 1003201955 PECOS PAC ID: 8426225251 Enrollment ID: O20120225000071 |
---|
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Sreedhar Reddy Mitta is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Sreedhar Reddy Mitta, 2425 Fairlawn Dr, Carthage, MO 64836-3517 Ph: (417) 237-0983 | Sreedhar Reddy Mitta, 2425 Fairlawn Dr, Carthage, MO 64836-3517 Ph: (417) 237-0983 |
Reviews and Comments