Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Praveen Anuradha Walaliyadda, MD

Individual provider Geriatric Medicine (Internal Medicine) Physician · NPI 1710515135

Praveen Anuradha Walaliyadda, MD is a Geriatric Medicine in Pocatello, Idaho. Qualified in 2020, 6 years ago. Licensed in Idaho.

Years since qualifying
6
Licensed in
ID
In the registry since
2020
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

1448 E Center St Ste E
Pocatello, ID 83201-4132
Phone: (208) 234-1300
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Rheumatology Physician (primary) Taxonomy 207RR0500X · Licence M-16603 (ID)
Geriatric Medicine (Internal Medicine) Physician Taxonomy 207RG0300X · Licence M16603 (ID)

Record details

NPI number1710515135
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 31, 2020
Last updated in NPPESJune 29, 2026
Certification dateJune 29, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGERIATRIC MEDICINE
Also practisesINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Accepts Medicare assignment Not indicated