Dr. Srinivasa Reddy Vaka, MD

Internal Medicine in Maple Grove, MN. Individual provider (NPI-1).

NPI number1184863938

StatusActive

Last updated in NPPESSep 23, 2019

Details

NPI: 1184863938
Entity type: Individual (NPI-1)
Name: Dr. Srinivasa Reddy Vaka
Credential: MD
Sex: Male
Sole proprietor: Yes
Enumeration date: Feb 17, 2009
Last updated: Sep 23, 2019

Medicare and OIG

Medicare enrolled (PECOS): Yes · PRACTITIONER - INTERNAL MEDICINE
Can order and refer: Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207R00000X	Internal Medicine	65117	MN	Yes
207R00000X	Internal Medicine	E7137	AR
208M00000X	Hospitalist	E7137	AR

Practice location

Fairview Clinics-Bass Lake
6320 Wedgwood Rd N
Maple Grove, MN 55311-3647

Phone 763-268-0400 · Fax 763-268-0405

Mailing address

Fairview Clinics-Bass Lake
6320 Wedgwood Rd N
Maple Grove, MN 55311-3647

Phone 763-268-0400 · Fax 763-268-0405

Other practice locations

1 Medical Park Dr
Benton, AR 72015-3353

Phone 501-776-6093 · Fax 501-776-6019

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Internal Medicine Physician providers in Maple Grove, MN

All 26 Internal Medicine Physician providers in Maple Grove · All 2,061 providers in Maple Grove

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