Individual provider Active NPI

Sujatha Srikanth, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Palm Springs, CA
National Provider Identifier
1124085287
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
A79529 Issued in CA
Practice address
1180 N Indian Canyon Dr Ste E421
Palm Springs, CA 92262-4882
Phone
(607) 424-8224
Fax
(760) 424-8227
NPI assigned
May 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X A79529 CA Primary

Addresses

Primary practice location

1180 N Indian Canyon Dr Ste E421
Palm Springs, CA 92262-4882

Mailing address

1180 N Indian Canyon Dr Ste E421
Palm Springs, CA 92262-4882
Phone (607) 424-8224

Other identifiers 1

IdentifierTypeStateIssuer
00A795290MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20051006000571 CA Practitioner - Internal MedicinePractitioner - Endocrinology 1355366535 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79529CAMDPharmacist
A79529CAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
First Choice Physician Partners CurrentSince Jan 1, 2021 Accepting new patients
First Choice Physician Partners Current Accepting new patients
First Choice Physician Partners Pediatric Endocrinology CurrentSince Jan 1, 2021 Accepting new patients
First Choice Physician Partners Endocrinology, Diabetes & Metabolism Current Accepting new patients
Chaparral Medical Group Inc CurrentSince Aug 11, 2018 Accepting new patients
Chaparral Medical Group, Inc. Current Accepting new patients
Chaparral Medical Group, Inc. Endocrinology, Diabetes & Metabolism Current Accepting new patients
Chaparral Medical Group Inc. CurrentSince Aug 11, 2018 Accepting new patients
Chaparral Medical Group, Inc. CurrentSince Aug 11, 2018 Accepting new patients
Diagnostic Imaging Services Past Accepting new patients
Fresno Community Hospital and Medical Center Past Accepting new patients
Central California Faculty Medical Group, Inc. Endocrinology, Diabetes & Metabolism Past Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients
White Memorial Medical Center Past Accepting new patients

Locations

5475 Walnut Ave
Chino, CA 91710
Phone (909) 591-6446

1541 Florida Ave
Ste 101
Modesto, CA 95350
Phone (209) 575-3839

1180 N Indian Canyon Dr
Ste E421
Palm Springs, CA 92262
Phone (760) 424-8224

1801 W Olympic Blvd
Pasadena, CA 91199

840 Towne Center Dr
Pomona, CA 91767

1880 N Orange Grove Ave
Pomona, CA 91767
Phone (909) 620-7200

1866 N Orange Grove Ave
Ste 202
Pomona, CA 91767
Phone (909) 623-8796

790 E Bonita Ave
Pomona, CA 91767
Phone (909) 625-7207

9190 Haven Ave
Ste 101
Rancho Cucamonga, CA 91730
Phone (909) 581-6732

8330 Red Oak St
Ste 101
Rancho Cucamonga, CA 91730
Phone (909) 987-4922

35800 Bob Hope Dr
Ste 225
Rancho Mirage, CA 92270
Phone (760) 324-4466

58457 29 Palms Hwy
Ste 200
Yucca Valley, CA 92284
Phone (760) 228-1813

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1124085287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 N INDIAN CANYON DR STE E421",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922624882",
            "telephone_number": "607-424-8224",
            "fax_number": "760-424-8227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 N INDIAN CANYON DR STE E421",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922624882",
            "telephone_number": "607-424-8224",
            "fax_number": "760-424-8227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRIKANTH",
        "first_name": "SUJATHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-01",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A79529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A795290",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, CA

Sources for this page

Verify at the official NPI Registry.