NPIMap

Individual provider Active NPI

Sreekala Raghavan, MD

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1184912578
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
270371 Issued in NY
Practice address
10 Union SQ E
New York, NY 10003-3314
Phone
(212) 844-8100
NPI assigned
Jul 19, 2011
Last updated
Aug 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 270371 NY Primary

Addresses

Primary practice location

10 Union SQ E
New York, NY 10003-3314

Mailing address

1 Gustave L Levy PL # 1118
New York, NY 10029-6504

Other practice location 1

25611 Union Tpke
Glen Oaks, NY 11004-1251
Phone (929) 292-7000

Other practice location 2

First Avenue at 16TH Street
New York, NY 10003
Phone (212) 844-8100

Other identifiers 1

IdentifierTypeStateIssuer
03603770MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140228001462 NY Practitioner - Internal Medicine 5799915278 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10 Union SQ E
New York, NY 10003-3314
Phone (212) 844-8100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
270371NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Internal Medicine CurrentSince Mar 11, 2019 Accepting new patients
Montefiore Medical Center Internal Medicine CurrentSince Jun 21, 2013 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Montefiore Medical Center CurrentSince Jun 21, 2013 Accepting new patients
Icahn School of Medicine at Mount Sinai Internal Medicine CurrentSince Jul 1, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 1, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

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

25611 Union Tpke
Glen Oaks, NY 11004
Phone (718) 470-4000

300 Community Dr
Manhasset, NY 11030

10 Union Sq E
New York, NY 10003
Phone (212) 253-6800

17 E 102nd St
New York, NY 10029
Phone (212) 241-7968

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Organizations & group practices 7

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.

Hospital & facility affiliations 10

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": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1184912578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL # 1118",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 UNION SQ E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033314",
            "telephone_number": "212-844-8100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25611 Union Tpke",
            "address_purpose": "LOCATION",
            "city": "Glen Oaks",
            "state": "NY",
            "postal_code": "110041251",
            "country_code": "US",
            "telephone_number": "929-292-7000",
            "fax_number": "929-292-7001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "FIRST AVENUE AT 16TH STREET",
            "address_purpose": "LOCATION",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10003",
            "country_code": "US",
            "telephone_number": "212-844-8100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAGHAVAN",
        "first_name": "SREEKALA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-19",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "270371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03603770",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.