Amanda Ann Srinivasan, PA-C

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

25MP00615000 Issued in NJ

Practice address

510 Jackson Ave
Northfield, NJ 08225-1631

Phone

(609) 383-0200

Fax

(609) 383-8352

NPI assigned

Apr 20, 2021

Last updated

May 5, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northeast Kidney Care LLCGroup PAC ID 8921445032, 66 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Atlanticare Regional Medical Center - City Campus Hospital, Atlantic City, NJ, CCN 310064

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: asrinivasan31932@direct.acumenmd.com

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

• Northeast Kidney Care LLC

  • Internal Medicine Physician
  • Brick, NJ
  • NPI 1023889565
  Medicare reassignment Care Compare group
• Regional Nephrology Associates, P.a.

  • Nephrology Physician
  • Northfield, NJ
  • NPI 1982613113
  Medicare reassignment

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

• Atlanticare Regional Medical Center

  • General Acute Care Hospital
  • Pomona, NJ
  • NPI 1013919315
  Care Compare affiliation

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

{
    "created_epoch": "1618876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1073194171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 24TH ST S",
            "city": "BRIGANTINE",
            "state": "NJ",
            "postal_code": "082031834",
            "telephone_number": "570-401-8016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 JACKSON AVE",
            "city": "NORTHFIELD",
            "state": "NJ",
            "postal_code": "082251631",
            "telephone_number": "609-383-0200",
            "fax_number": "609-383-8352"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 24th St S",
            "address_purpose": "LOCATION",
            "city": "Brigantine",
            "state": "NJ",
            "postal_code": "082031834",
            "country_code": "US",
            "telephone_number": "570-401-8016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SRINIVASAN",
        "first_name": "AMANDA",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-20",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "25MP00615000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Amanda T Stewart, LCSW
• Zoryana Stoyko, M.D.
• Strive Physical Therapy Specialists
• Kaliroi Subashi, LAC

• Nephrology Physician in Northfield, NJ
• Providers in Northfield, NJ by specialty
• Nephrology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.