SASIKALA ROYYURU (NPI# 1982800876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982800876 |
| Entity Type | Individual |
| Full Name | SASIKALA ROYYURU |
| Credential | MD |
| Practice Address |
3024 E Empire St Bloomington IL 61704-5402 |
| Mailing Address |
701 Lee St Des Plaines IL 60016-4539 |
| Practice Telephone | 3095567700 |
| Mailing Telephone | 8473905900 |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2013-06-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 036126335 | IL | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 38092 | IA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 57009749 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICARE RURAL HEALTH NUMBER | 143821 | 01 |
| IL | BCBS | 3932056 | 01 |
| IA | 1982800876 | 05 | |
| IL | 036126335 | 05 | |
| IL | AETNA | 721089 | 01 |
| Street Address |
3024 E EMPIRE ST |
| City | BLOOMINGTON |
| State | IL |
| Zip Code | 61704-5402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922212638 | Rhoda Jean Gottfried | Psychiatry & Neurology | 3024 E Empire St, 2nd Floor Suite A, Bloomington, IL 61704-5402 | 2007-05-10 |
| 1538700851 | Cameron Troy Jackson Stengel | Physician Assistant | 3024 E Empire St, Bloomington, IL 61704-5402 | 2019-10-08 |
| 1497206551 | Jennifer Victoria Menendez | Physician Assistant | 3024 E Empire St, Bloomington, IL 61704-5402 | 2016-10-24 |
| 1578951075 | Desha Cobb | Nurse Practitioner | 3024 E Empire St, Bloomington, IL 61704-5402 | 2015-01-06 |
| 1770989220 | Jennifer Gibb | Nurse Practitioner | 3024 E Empire St, Bloomington, IL 61704 | 2014-11-11 |
| 1770828626 | Dermatology and Mohs Surgery Institute, Ltd. | Specialist | 3024 E Empire St, 2nd Floor, Suite F, Bloomington, IL 61704-5402 | 2012-12-04 |
| 1902131014 | David Milligan | Pediatrics | 3024 E Empire St, Bloomington, IL 61704-5402 | 2009-10-07 |
| 1285804724 | Andrea Michelle Kane | Pediatrics | 3024 E Empire St, Bloomington, IL 61704-5402 | 2008-03-11 |
| 1083890156 | Aaron Reid Traeger | Pediatrics | 3024 E Empire St, Bloomington, IL 61704-5402 | 2008-01-18 |
| 1255523296 | Douglas Michael Leone | Dermatology | 3024 E Empire St, Ste E & F, Bloomington, IL 61704-5402 | 2007-08-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518430859 | Visionpoint Eye Center LLC | Optometrist | 1107 Airport Road, Bloomington, IL 61704 | 2019-01-09 |
| 1922588235 | Geethu Sabu Makil | Speech-Language Pathologist | 1039 Blueheron Way, Apt#3, Bloomington, IL 61704 | 2018-08-16 |
| 1629596812 | Mental Wellness Center Inc | Counselor | 202 N Prospect Rd Ste 207, Bloomington, IL 61704 | 2017-09-07 |
| 1649798513 | Sarah Goodner | Psychologist | 1704 Royal Pointe Drive, Bloomington, IL 61704 | 2017-08-31 |
| 1346760253 | Elizabeth Devlin | Nurse Practitioner | 25 Long Cove Ct, Bloomington, IL 61704 | 2017-06-21 |
| 1396107918 | Darla Schwertfeger | Specialist/Technologist, Other | 2104 Hedgewood Dr, Bloomington, IL 61704 | 2016-03-23 |
| 1740662949 | Oncology Hematology Associates of Central Illinois | Pharmacy | 3105 Magory Drive, Bloomington, IL 61704 | 2015-06-24 |
| 1821478967 | Kelly R Andrews | Massage Therapist | 4101 Wicker Rd, Bloomington, IL 61704 | 2015-06-03 |
| 1235522582 | All Ways Caring Services, Inc. | In Home Supportive Care | 209 S Prospect Rd, Suite 3e, Bloomington, IL 61704 | 2015-03-11 |
| 1396093977 | Bhawna Gupta | Physical Therapist | 2200 East Washington Street, Bloomington, IL 61704 | 2012-08-29 |
| Find all providers in zip 61704 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073165650 | Genevieve Elon Monge | Family Medicine | 18651 Valley Blvd, Bloomington, CA 92316-1831 | 2019-07-12 |
| 1982117172 | Andry Medical Services | Family Medicine | 451 S Park Ridge Rd Ste 101, Bloomington, IN 47401-8589 | 2017-11-09 |
| 1033459904 | Charles R Farmer | Family Medicine | 3480 S Oak Ridge Dr, Bloomington, IN 47401-8926 | 2013-02-28 |
| 1467798504 | James Anthony Ray | Family Medicine | 2001 E Hillside Dr Lot 4, Bloomington, IN 47401-6692 | 2012-12-18 |
| 1902140585 | Fountain Healthcare Limited Liability Company | Family Medicine | 2412 E Washington St Ste 6, Bloomington, IL 61704-4497 | 2012-11-20 |
| 1306147236 | Community Health Network | Family Medicine | 524 N Fairview St, Bloomington, IN 47404-3774 | 2010-11-09 |
| 1942501978 | Premier Medical Group, LLC | Family Medicine | 2102 E Washington St, Bloomington, IL 61701-4321 | 2010-11-08 |
| 1356660666 | Glen Edward Tomlinson | Family Medicine | 42 Crista Ann Ct, Bloomington, IL 61704-8699 | 2010-05-26 |
| 1285862664 | Charles W Mcclary | Family Medicine | 1411 S Sare Rd, Bloomington, IN 47401-4431 | 2009-06-24 |
| 1982840005 | Thomas Patterson Cairns | Family Medicine | 10258 Berkshire Rd, Bloomington, MN 55437-2265 | 2008-12-18 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 61704 |
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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.