Shyam Poludasu (NPI# 1811171705, PAC ID# 3072648518) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERVENTIONAL CARDIOLOGY.
| Nation Provider ID (NPI) | 1811171705 |
| PAC ID by PECOS | 3072648518 |
| Professional Enrollment ID | I20120215000723 |
| Full Name | Shyam Poludasu |
| Organization Legal Name | STILLWATER MEDICAL CENTER AUTHORITY |
| Address |
1301 W 6th Ave Suite 207 Stillwater OK 74074-4381 |
| Phone Number | 4055333010 |
| Gender | M |
| Graduation Year | 2000 |
| Primary Specialty | INTERVENTIONAL CARDIOLOGY |
| Secondary Specialties | CARDIOVASCULAR DISEASE (CARDIOLOGY) |
| Group Practice PAC ID | 2365353794 |
| Number of Group Practice Members | 126 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 370049 | STILLWATER MEDICAL CENTER |
| 370139 | PERRY MEMORIAL HOSPITAL AUTHORITY |
| 370006 | PONCA CITY MEDICAL CENTER |
| 370001 | HILLCREST MEDICAL CENTER |
| 370030 | BLACKWELL REGIONAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1301 W 6th Ave, Suite 207, Stillwater, OK 74074-4381 | 4055333010 | STILLWATER MEDICAL CENTER AUTHORITY |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_EP_1 | e-Prescribing | 95% | |
| ACI_EC_TRANS_HIE_1 | Health Information Exchange | 11% | |
| ACI_EC_TRANS_MR_1 | Medication Reconciliation | 96% | |
| ACI_EC_TRANS_PEA_1 | Provide Patient Access | 68% | |
| ACI_EC_TRANS_PEA_2 | View, Download, or Transmit (VDT) | 12% | |
| ACI_EC_TRANS_PHCDRR_1 | Immunization Registry Reporting | % | |
| ACI_EC_TRANS_PHCDRR_3 | Specialized Registry Reporting | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| ACI_EC_TRANS_PSE_1 | Patient-Specific Education | 65% | |
| ACI_EC_TRANS_SM_1 | Secure Messaging | 1% | |
| MIPS_EC_006_overall | Coronary Artery Disease (CAD): Antiplatelet Therapy | 93% | |
| MIPS_EC_438_overall | Statin Therapy for the Prevention and Treatment of Cardiovascular Disease | 100% |
| Organization Legal Name | STILLWATER MEDICAL CENTER AUTHORITY |
| Physicians | 110 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jaime Lyn Griffith | Family Medicine | Stillwater Medical Center Authority | 600 S Linwood Ave A, Cushing Primary Care, Cushing, OK 74023-4630 |
| Rahmah Hall | Physician Assistant | Stillwater Medical Center Authority | 1412 Fir St, Perry, OK 73077-5036 |
| Jeremiah Bro | Nurse Practitioner | Stillwater Medical Center Authority | 1301 W 6th Ave, Suite 207, Stillwater, OK 74074-4381 |
| Catherine Kindt | Nurse Practitioner | Stillwater Medical Center Authority | 1815 W 6th Ave, Stillwater Med C Clinic W, Stillwater, OK 74074-2402 |
| Julia K Fell | Physician Assistant | Stillwater Medical Center Authority | 417 Fairview Ave, Ponca City, OK 74601-1923 |
| Jon M Johnson Ii | Internal Medicine | Stillwater Medical Center Authority | 608 S Hester, Stillwater, OK 74074-4516 |
| Marshall A Walker | Optometry | Stillwater Medical Center Authority | 707 S Western Rd, Stillwater, OK 74074-4126 |
| Mindy A Mcgee | Physician Assistant | Stillwater Medical Center Authority | 414 W Hwy 64, Morrison, OK 73061-9494 |
| William R Ford | Obstetrics/gynecology | Stillwater Medical Center Authority | 1411 W 7th Ave, 202 Sw Women's Clinic, Stillwater, OK 74074-4300 |
| Robert W Lauvetz | Urology | Stillwater Medical Center Authority | 816 S Pine St, Stillwater, OK 74074-4349 |
| Street Address |
1301 W 6TH AVE SUITE 207 |
| City | STILLWATER |
| State | OK |
| Zip | 74074-4381 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jeremiah Bro | Nurse Practitioner | Stillwater Medical Center Authority | 1301 W 6th Ave, Suite 207, Stillwater, OK 74074-4381 |
| Shanna L Douglass | Nurse Practitioner | Stillwater Medical Center Authority | 1301 W 6th Ave, Suite 207, Stillwater, OK 74074-4381 |
| Jerrod L Vaughn | General Surgery | Stillwater Medical Center Authority | 1301 W 6th Ave, 105 Stillwater Surg Assoc, Stillwater, OK 74074-4376 |
| James B Harris | Cardiovascular Disease (cardiology) | Stillwater Medical Center Authority | 1301 W 6th Ave, Suite 207, Stillwater, OK 74074-4381 |
| Cara D Pence | General Surgery | Stillwater Medical Center Authority | 1301 W 6th Ave, 105 Stillwater Surg Assoc, Stillwater, OK 74074-4376 |
| Jawad M Trad | Cardiovascular Disease (cardiology) | Stillwater Medical Center Authority | 1301 W 6th Ave, Suite 207, Stillwater, OK 74074-4381 |
| Mirabel Forteh | Nurse Practitioner | Stillwater Medical Center Authority | 1301 W 6th Ave, Suite 207, Stillwater, OK 74074-4381 |
| Akinola O Ogundipe | Hematology/oncology | Stillwater Medical Center Authority | 1301 W 6th Ave, Stillwater, OK 74074-4376 |
| Arthur D Hagan | Cardiovascular Disease (cardiology) | Stillwater Medical Center Authority | 1301 W 6th Ave, Suite 208, Stillwater, OK 74074-4381 |
| George Darby Pope | Thoracic Surgery | Stillwater Medical Center Authority | 1301 W 6th Ave, 105 Stillwater Surg Assoc, Stillwater, OK 74074-4376 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Charles R Horner Jr. | Diagnostic Radiology | Stillwater Radiology LLC | 4721 W 6th Ave, Suite 130, Stillwater, OK 74074-1549 |
| Brandon R Mason | Diagnostic Radiology | Stillwater Radiology LLC | 4721 W 6th Ave, Suite 130, Stillwater, OK 74074-1549 |
| Phillip G Russell | Diagnostic Radiology | Stillwater Radiology LLC | 4721 W 6th Ave, Suite 130, Stillwater, OK 74074-1549 |
| Kenda G Baker | Physician Assistant | Oliver Street 5.01(a) Inc. | 1329 S Sangre Rd, Us Dermatology Partners, Stillwater, OK 74074-1854 |
| Thomas C Hall | Dermatology | Oliver Street 5.01(a) Inc. | 1329 S Sangre Rd, Us Dermatology Partners, Stillwater, OK 74074-1854 |
| Deanna J Cummings | Physician Assistant | Oliver Street 5.01(a) Inc. | 1329 S Sangre Rd, Us Dermatology Partners, Stillwater, OK 74074-1854 |
| Sara K Metcalf | Dermatology | Oliver Street 5.01(a) Inc. | 1329 S Sangre Rd, Us Dermatology Partners, Stillwater, OK 74074-1854 |
| J Weston H. Reese | Chiropractic | Reese Chiropractic and Wellness, P.C. | 1505 S Sangre Rd, Stillwater, OK 74074-1869 |
| Ashton Nicole Shelton | Chiropractic | Reese Chiropractic and Wellness, P.C. | 1505 S Sangre Rd, Stillwater, OK 74074-1869 |
| Jennifer Pauline Childers | Clinical Social Worker | Jennifer Childers Lcsw Counseling LLC | 2324 W 7th Pl, Stillwater, OK 74074-1927 |
| Find all physicians in zip 74074 | |||
| City | STILLWATER |
| Zip Code | 74074 |
| Specialty | INTERVENTIONAL CARDIOLOGY |
| City + Specialty | STILLWATER + INTERVENTIONAL CARDIOLOGY |
Please comment or provide details below to improve the information on Shyam Poludasu.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.