Sriniwasan Mani

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Green Brook, NJ

NPI 1003340654 · NPPES record last updated Oct 27, 2023

Key facts

NPI
1003340654
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
1028 Robin CT
Green Brook, NJ 08812-1736
Phone
(630) 345-0559
NPI assigned
Apr 19, 2017
Sex
Male
Sole proprietor
Yes

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Urology
Education
Georgetown University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southern California Permanente Medical Group (11,250 clinicians)

Practice addresses (Care Compare)

13652 Cantara St
Panorama City, CA 91402-5423
Phone (818) 375-2000

Hospital & facility affiliations

  • Kaiser Foundation Hospital - Panorama City Hospital · Panorama City, CA · CCN 050137

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20230801002816 CA Practitioner - Urology 1557722907 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Current
since Jun 26, 2023
Accepting new patients
Permanente Medical Group, Inc Current
since Jun 26, 2023
Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group Current
since Sep 17, 2023
Accepting new patients
Southern California Permanente Medical Group Current
since Sep 17, 2023
Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

1800 Harrison St
Fl 7
Oakland, CA 94612

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

1600 Eureka Rd
Roseville, CA 95661
Phone (916) 474-7777

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

1028 Robin CT
Green Brook, NJ 08812-1736

Mailing address

1028 Robin CT
Green Brook, NJ 08812-1736
Phone (630) 345-0559

Electronic endpoints

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Other providers in Green Brook, NJ

All providers in Green Brook, NJ · Student in an Organized Health Care Education/Training Program in New Jersey

Sources for this page

Verify at the official NPI Registry.