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MS. SREELAKSHMI REDDIVARI PA
NPI 1093075038
Physician Assistant - Surgical in Farmington, CT

Active since May 24, 2012PECOS EnrolledAccepts Medicare Assignment
263 FARMINGTON AVE, GENERAL SURGERY, FARMINGTON, CT 06030(860) 679-8080(860) 679-1420 Get Directions Write a Review

NPPES record last updated: July 11, 2022. Verified against the NPPES registry weekly; last sync: September 13, 2026.

Record update history: Jul 11, 2022, Nov 12, 2018, Oct 1, 2015 (3 updates tracked since 2015).

About Ms. Sreelakshmi Reddivari Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. SREELAKSHMI REDDIVARI PA (NPI 1093075038) is an individual surgical provider in Farmington, Connecticut, licensed in Connecticut (002736) and active in the NPI registry since May 2012. She is enrolled in Medicare PECOS, maintains a secondary practice location in Derby, and is a graduate of Other (2011).

NPPES Registry Identity

NPI1093075038
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NameMS. SREELAKSHMI REDDIVARICredential: PA
Location Address263 FARMINGTON AVE, GENERAL SURGERYFarmington, CT 06030-6227
Mailing Address263 Farmington Ave, Provider Enrollment Office, Mc2212Farmington, CT 06030-2212 · (860) 679-7503 · Fax (860) 679-1610
Phone(860) 679-8080
Fax(860) 679-1420
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateMay 24, 2012
Last NPPES UpdateJuly 11, 20223 updates tracked since enumeration
✔ NPI 1093075038 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in CT · 002736
263 FARMINGTON AVE, Farmington, CT 06030
Open in Google Maps ↗

Secondary Practice Location 1

Location 1130 Division StDerby, CT 06418-1326 · Phone (203) 732-1330 · Fax (203) 732-1332

Other Identifiers 1

Medicaid1093075038CT

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Sreelakshmi Reddivari Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1456515675
PECOS Enrollment IDI20120619000245
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STATE OF CONNECTICUT HEALTH CENTER
Pathology (Anatomic Pathology & Clinical Pathology)
263 FARMINGTON AVE, LABORATORY HBP GROUP
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-7503
MR. IAN THOMAS MCNEILL
Neurological Surgery
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-8080
DR. LUIS CHAVEZ DE PAZ DDS, MS, PHD
Dentist (Endodontics)
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-2719
TARUNYA REDDY VEDERE
Internal Medicine (Endocrinology, Diabetes & Metabolism)
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-3245
ZACHARY TALLENT SOLOMON
Surgery
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-3467
MICHAEL CONNOLLY
Psychiatry & Neurology (Psychiatry)
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-4733
EMILY WENG DO
Internal Medicine (Gastroenterology)
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-3158
ANDREW KEMERLEY DO
Student in an Organized Health Care Education/Training Program
263 FARMINGTON AVE
FARMINGTON, CT 06030
Capitol Planning Region (860) 679-3467

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sreelakshmi Reddivari's NPI number?

The NPI number for Sreelakshmi Reddivari is 1093075038. It was assigned to this individual provider in the NPPES registry on May 24, 2012.

Where is Sreelakshmi Reddivari located?

Sreelakshmi Reddivari practices at 263 Farmington Ave General Surgery, Farmington, CT 06030. The listed phone number is (860) 679-8080.

What is Sreelakshmi Reddivari's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Sreelakshmi Reddivari enrolled in Medicare?

Yes. Sreelakshmi Reddivari is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Sreelakshmi Reddivari was last updated on July 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.