| Durga Sivacharan Gaddam, | |
|
1304 Fawcett Ave Ste 100, Tacoma, WA 98402-1900 | |
| (253) 761-4200 | |
| Not Available |
| Full Name | Durga Sivacharan Gaddam |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 9 Years |
| Location | 1304 Fawcett Ave Ste 100, Tacoma, Washington |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487018578 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | A172641 (California) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | MD61443065 (Washington) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Centura Health-penrose St Francis Health Services | Colorado springs, CO | Hospital |
| Tacoma General Allenmore Hospital | Tacoma, WA | Hospital |
| Multicare Good Samaritan Hospital | Puyallup, WA | Hospital |
| Multicare Covington Medical Center | Covington, WA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Florida Hospital Medical Group Inc | 0042383200 | 279 |
| Florida Radiology Imaging At Lake Mary Llc | 1254311137 | 217 |
| Penrad Imaging Llc | 1850387598 | 23 |
| Tra-minw P S | 2163316167 | 140 |
| Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance | 3375603970 | 103 |
| Union Avenue Open Mri Llc | 5597652917 | 42 |
| Colorado Springs Radiologists Pc | 6901890094 | 24 |
| Florida Hospital Medical Group Inc | 0042383200 | 279 |
| Florida Radiology Imaging At Lake Mary Llc | 1254311137 | 217 |
| Penrad Imaging Llc | 1850387598 | 23 |
| Colorado Springs Radiologists Pc | 6901890094 | 24 |
| Entity Name | Tra-minw P S |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396814166 PECOS PAC ID: 2163316167 Enrollment ID: O20040211000326 |
| Entity Name | Union Avenue Open Mri Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568531242 PECOS PAC ID: 5597652917 Enrollment ID: O20040301001189 |
| Entity Name | Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1083802946 PECOS PAC ID: 3375603970 Enrollment ID: O20081126000315 |
| Entity Name | Tmc Radiology Cra Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851046726 PECOS PAC ID: 4486041746 Enrollment ID: O20230801002088 |
| Entity Name | Mw Radiology-cra Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114555398 PECOS PAC ID: 6406270040 Enrollment ID: O20230802001158 |
| Entity Name | Florida Radiology Imaging At Lake Mary Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740256494 PECOS PAC ID: 1254311137 Enrollment ID: O20240315002312 |
| Entity Name | Florida Hospital Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073785044 PECOS PAC ID: 0042383200 Enrollment ID: O20240319003796 |
| Entity Name | Colorado Springs Radiologists Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629168406 PECOS PAC ID: 6901890094 Enrollment ID: O20241001003060 |
| Entity Name | Penrad Imaging Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003906868 PECOS PAC ID: 1850387598 Enrollment ID: O20241023000574 |
| Entity Name | Florida Hospital Physician Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174955256 PECOS PAC ID: 2365679057 Enrollment ID: O20250522002308 |
| Mailing Address | Practice Location Address |
|---|---|
| Durga Sivacharan Gaddam, 300 Pasteur Dr, Stanford, CA 94305-2200 Ph: (650) 723-4000 | Durga Sivacharan Gaddam, 1304 Fawcett Ave Ste 100, Tacoma, WA 98402-1900 Ph: (253) 761-4200 |
Dr. Yuyao Zhang, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1304 Fawcett Ave Ste 100, Tacoma, WA 98402 Phone: 253-761-4201 Fax: 253-761-4201 | |
Mark Ranier Dalisay, Radiology Medicare: Not Enrolled in Medicare Practice Location: 7520 S I St, Tacoma, WA 98408 Phone: 702-305-1889 | |
Dr. Joel Thomas Mcfarland, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 209 Martin Luther King Jr Way, Tacoma, WA 98405 Phone: 253-596-3300 Fax: 253-596-3301 | |
Dr. Jana Lynn Fahmy, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1304 Fawcett Ave Ste 100, Tacoma, WA 98402 Phone: 253-761-4200 Fax: 253-761-4201 | |
Dr. Scott Randall Henneman, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1304 Fawcett Ave Ste 100, Tacoma, WA 98402 Phone: 253-761-4200 Fax: 253-761-4201 | |
Dr. Mark Gerard O'callaghan, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 209 Martin Luther King Jr Way, Tacoma, WA 98405 Phone: 253-596-3300 | |
Dr. Joseph Tsai, MD, PHD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1003 S 5th St, Tacoma, WA 98405 Phone: 253-403-4994 Fax: 253-403-4991 |