SIRISH KUMAR KONDABOLU (NPI# 1821354176) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821354176 |
| Entity Type | Individual |
| Full Name | SIRISH KUMAR KONDABOLU |
| Practice Address |
912 Russell Dr Lebanon PA 17042 |
| Mailing Address |
3421 Concord Rd York PA 17402-9001 |
| Practice Telephone | 7172727971 |
| Practice Fax Number | 7172721241 |
| Mailing Telephone | 7178511405 |
| Mailing Fax Number | 7178516969 |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2019-01-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | MD465257 | PA | Allopathic & Osteopathic Physicians |
| N | 207X00000X | Orthopaedic Surgery | 275452 | NY | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| Stony Brook University Medical Center, Department of Orthopaedics, Hsc T-18, Stony Brook, NY 117948181 | 6314441487 |
| Street Address |
912 RUSSELL DR |
| City | LEBANON |
| State | PA |
| Zip Code | 17042 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225013642 | Robert Campbell | Anesthesiology | 912 Russell Dr, Lebanon, PA 17042-7485 | 2005-12-08 |
| 1205308954 | Wellspan Medical Group | Preventive Medicine | 912 Russell Dr, Lebanon, PA 17042-7485 | 2018-12-19 |
| 1932573482 | Erika J Peavy | Physician Assistant | 912 Russell Dr, Lebanon, PA 17042-7485 | 2015-11-20 |
| 1477927408 | Amy Jo Krall | Nurse Practitioner | 912 Russell Dr, Lebanon, PA 17042-7485 | 2015-11-13 |
| 1861759342 | Ian M Yarger | Podiatrist | 912 Russell Dr, Lebanon, PA 17042-7485 | 2012-04-20 |
| 1851687362 | Jitesh Umarvadia | Family Medicine | 912 Russell Dr, Lebanon, PA 17042-7485 | 2011-06-22 |
| 1932417128 | Anthony Guy Helwig | Orthopaedic Surgery | 912 Russell Dr, Lebanon, PA 17042-7485 | 2010-09-22 |
| 1770777427 | Wendy Lynn Updegrove | Physician Assistant | 912 Russell Dr, Lebanon, PA 17042-7485 | 2007-09-05 |
| 1881892172 | David Trigg Streets | Orthopaedic Surgery | 912 Russell Dr, Lebanon, PA 17042-7485 | 2007-07-07 |
| 1417972902 | Scott M. Williams | Orthopaedic Surgery | 912 Russell Dr, Lebanon, PA 17042 | 2006-07-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023676384 | Sandra L Pistone | Registered Nurse | 905 S. 2nd Ave, Lebanon, PA 17042 | 2019-06-03 |
| 1154848414 | Kihc, LLC | Home Health | 900-c Centerville Road, Suite C, Lancaster, PA 17042 | 2017-08-28 |
| 1316301724 | Good Samaritan Physician Services | Radiology | 844 Tuck Street, Lebanon, PA 17042 | 2016-04-12 |
| 1609265883 | Ashley Hess | Behavioral Analyst | 15th South 9th Street, Lebanon, PA 17042 | 2015-01-12 |
| 1932504727 | Anthony Salvadore Petrole | Physician Assistant | 252 4th Street, Lebanon, PA 17042 | 2014-10-23 |
| 1801209713 | Matthew Johnson | Family Medicine | 920 Church Street, Lebanon, PA 17042 | 2014-06-09 |
| 1437414505 | Odalys Gonzalez-rodriguez | Physical Therapist | 1700 S Lincoln Ave., Lebanon Vmac Bldg 102 Room 120, Lebanon, PA 17042 | 2012-07-05 |
| 1750677175 | Anita Lyn Stokes | Speech-Language Pathologist | 1126 Walnut Street, Lebanon, PA 17042 | 2011-06-23 |
| 1205126497 | Karey Lynn Foote | Pharmacist | 415 S. 9th St, Lebanon, PA 17042 | 2011-04-09 |
| 1013227685 | T. W. Ponessa and Associates Counseling Services, Inc. | Community/Behavioral Health | 101 E. Evergreen Road, Lebanon, PA 17042 | 2010-10-18 |
| Find all providers in zip 17042 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750607131 | Timothy Joseph Lin | Orthopaedic Surgery | 1 Medical Center Drive Orthopaedics, Lebanon, NH 03766 | 2010-04-11 |
| 1518029388 | Regional Orthopedic Associates, P.C. | Orthopaedic Surgery | 410 Cumberland Street, Lebanon, PA 17042-1704 | 2006-12-15 |
| 1417900598 | William C. Robertson Jr. | Orthopaedic Surgery | 55 Twin Oaks Ave, Suite D-5, Lebanon, OR 97355-2864 | 2006-05-18 |
| 1184683179 | Petty Orthopaedics PC | Orthopaedic Surgery | 1616 W. Main St., Suite 300, Lebanon, TN 37087 | 2006-03-20 |
| 1861460958 | Terrance C Devlin | Orthopaedic Surgery | 2705 N Lebanon St Ste 210, Lebanon, IN 46052-8622 | 2006-03-14 |
| 1851367015 | Lance O Yarus | Orthopaedic Surgery | 410-12 Cumberland St, Lebanon, PA 17042-5314 | 2006-02-27 |
| 1952388712 | Leonard M. Rudolf | Orthopaedic Surgery | 17 Alice Peck Day Dr Unit C, Lebanon, NH 03766-2684 | 2005-12-22 |
| 1487639415 | John E Garber | Orthopaedic Surgery | 2705 N Lebanon St Ste 220, Lebanon, IN 46052-8622 | 2005-12-13 |
| 1649271206 | Roy C. Terry | Orthopaedic Surgery | 101 Physicians Way, Ste. 111, Lebanon, TN 37090 | 2005-08-04 |
| 1457998379 | Specialty Orthopedic Group Tennessee | Orthopaedic Surgery | 365 S Hartmann Dr Ste 106, Lebanon, TN 37087-4788 | 2019-12-10 |
| Find all providers in LEBANON | ||||
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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.