Individual ProviderSirisha SanamandraInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address20 York St, Yale New Haven Hospital, New Haven, CT 06510-3220(203) 688-4242(203) 785-6054PECOS EnrollmentBased on the most recent information from CMS, provider Sirisha Sanamandra is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:14 PM.Profile DetailsProvider ID1467730416Provider TypeIndividualFull NameSanamandra, SirishaTitleDr.CredentialM.D.GenderFemaleSole ProprietorYesEnumeration Date7/25/2011Last Updated9/26/2014Contact InformationPractice LocationPractice Address20 York St, Yale New Haven Hospital, New Haven, CT 06510-3220Phone(203) 688-4242FaxUnlisted FaxMailing LocationMailing Address15 York St, Lci 910, New Haven, CT 06510-3221Phone(203) 785-6054FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense53495ConnecticutCode207Q00000XDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense125059059IllinoisCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicense53495Connecticut