Individual provider Active NPI

Sriram S Iyer, MD

  • Interventional Cardiology Physician
  • New York, NY
National Provider Identifier
1013974617
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
207886 Issued in NY
Practice address
791 Park Ave
New York, NY 10021-3513
Phone
(212) 290-1300
Fax
(646) 219-2255
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 207886 NY
Cardiovascular Disease Physician 207RC0000X 31800 WI
Interventional Cardiology Physician 207RI0011X 207886 NY Primary

Addresses

Primary practice location

791 Park Ave
New York, NY 10021-3513

Mailing address

791 Park Ave
New York, NY 10021-3513
Phone (212) 290-1300

Other identifiers 1

IdentifierTypeStateIssuer
01782609MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040909000948 NY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 7911973938 Reassigns benefits to 2 organizations
I20200609000085 WI Practitioner - Cardiovascular Disease (Cardiology) 7911973938 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

725 American Ave
Waukesha, WI 53188-5031
Phone (262) 928-1000

791 Park Ave
New York, NY 10021-3513
Phone (212) 290-1300

Hospital & facility affiliations

  • Waukesha Memorial Hospital Hospital, Waukesha, WI, CCN 520008
  • Oconomowoc Memorial Hospital Hospital, Oconomowoc, WI, CCN 520062
  • Lenox Hill Hospital Hospital, New York, NY, CCN 330119

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Pacemaker insertion or repair1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
207886NYMDCardiovascular Disease Physician
31800WIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Long Island Jewish Health Care Inc Cardiovascular Disease CurrentSince Feb 1, 2012 Accepting new patients
Prohealth Medical Group Inc CurrentSince Feb 1, 2022 Accepting new patients
Sriram Iyer Medical, PC Interventional Cardiology CurrentSince Oct 1, 2014 Accepting new patients
Prohealth Medical Group Inc. CurrentSince Feb 1, 2022 Accepting new patients
North Shore Long Island Jewish Healthcare Cardiovascular Disease CurrentSince Feb 1, 2012 Accepting new patients
St John'S Medical Services PC Past Accepting new patients
Prohealth Medical Group Inc Cardiovascular Disease Past Accepting new patients
Lenox Hill Interventional Cardiac & Vascular Services PC Interventional Cardiology Past Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

1554 Northern Blvd
Manhasset, NY 11030
Phone (516) 390-9242

7554 Metropolitan Ave
Middle Vlg, NY 11379
Phone (718) 326-0400

130 E 77th St
Fl 9
New York, NY 10075
Phone (212) 434-2606

100 E 77th St
New York, NY 10075
Phone (212) 434-2606

130 E 77th St
New York, NY 10075
Phone (212) 434-2606

300 Community Dr
Plandome, NY 11030

431 Beach 129th St
Rockaway Park, NY 11694
Phone (718) 318-3434

791 Summit Ave
Summit, WI 53066
Phone (262) 569-0251

725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9979/brand/1/csg/1/fhir/r4
  • Direct secure messaging: siyer157086@direct.phci.org
  • Direct secure messaging: siyer64511@northwell.direct-ci.com
  • FHIR API: https://api.platform.athenahealth.com/14448/brand/1/csg/1/fhir/r4
  • Direct secure messaging: sriram.iyer.1@9979.direct.athenahealth.com

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 4

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1013974617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "791 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100213513",
            "telephone_number": "212-290-1300",
            "fax_number": "646-219-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "791 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100213513",
            "telephone_number": "212-290-1300",
            "fax_number": "646-219-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IYER",
        "first_name": "SRIRAM",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "207886",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "31800",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NY",
            "license": "207886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01782609",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.