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Srisai Saratdyuti Tenjerla

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

2635 Lawndale Dr, Greensboro, NC 27408-4802

PECOS Enrollment

This provider is enrolled in PECOS as SRISAI TENJERLA.

Based on the most recent information from CMS, provider Srisai Saratdyuti Tenjerla is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 11:21 AM.

Profile Details

Provider ID
1528849882
Provider Type
Individual
Full Name
Tenjerla, Srisai Saratdyuti
Title
Mrs.
Credential
PA-C

Gender
Female
Sole Proprietor
Yes
Enumeration Date
10/11/2023
Last Updated
1/21/2025

Contact Information

Practice Location

2635 Lawndale Dr, Greensboro, NC 27408-4802

(336) 867-4310

(336) 867-4311

Mailing Location

PO Box 601843, Charlotte, NC 28260-1843

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 0010-13813 North Carolina
Code 363A00000X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License Unlisted Issuer

Srisai Saratdyuti Tenjerla

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

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Description

License

Code

Description

License

Code

Description

License

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