Anil Kumar Srivastava, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

2004034166 Issued in MO

Practice address

12266 De Paul Dr Ste 305
Bridgeton, MO 63044-2514

Phone

(314) 770-0991

NPI assigned

Oct 3, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

General SurgeryAlso: Critical Care (Intensivists)

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Clinic Hyperbaric and Wound Care LLCGroup PAC ID 0345468526, 15 clinicians

Mercy Clinic Trauma and General Surgery LLCGroup PAC ID 1658320700, 44 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
• SSM St Clare Health Center Hospital, Fenton, MO, CCN 260081

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: asrivastava1350@directc.mercy.net

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.

• Mercy Clinic Hyperbaric and Wound Care LLC

  • Surgery Physician
  • Festus, MO
  • NPI 1336568864
  Medicare reassignment Care Compare group NPD
• Mercy Clinic Trauma and General Surgery, LLC

  • Trauma Surgery Physician
  • Saint Louis, MO
  • NPI 1699825695
  Medicare reassignment Care Compare group
• Mercy Clinic Surgical Specialists, LLC

  • Vascular Surgery Physician
  • Washington, MO
  • NPI 1043530538
  Medicare reassignment NPD
• St Louis Surgical Doctors Group LLC

  • Specialist
  • Saint Louis, MO
  • NPI 1417126210
  NPD (past) Authorized official
• St. Louis Surgical Doctors Group, LLC

  • Surgery Physician
  • Saint Louis, MO
  • NPI 1891941712
  NPD (past) Authorized official
• Mercy Hospitals East Communities

  dba Mercy Hospital St Louis

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1427098169

  Emergency Medicine

  NPD (past)
• Hospital & Medical Foundation of Paris, Inc.

  dba Horizon Health

  • Clinic/Center
  • Paris, IL
  • NPI 1629280367

  Surgery

  NPD (past)

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

• Mercy Hospitals East Communities

  dba Mercy Hospital St Louis

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1427098169
  Care Compare affiliation
• Mercy Hospitals East Communities

  dba Mercy St. Louis Transport Ambulance

  • Land Ambulance
  • Saint Louis, MO
  • NPI 1881329902

  Hospital

  Care Compare affiliation
• SSM Health Care St. Louis

  dba SSM Health St. Clare Hospital - Fenton

  • General Acute Care Hospital
  • Fenton, MO
  • NPI 1851496152
  Care Compare affiliation

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1205920220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 955534",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631955534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12266 DE PAUL DR STE 305",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442514",
            "telephone_number": "314-770-0991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "621 S. New Ballas Rd",
            "address_2": "Suite 560A",
            "address_purpose": "LOCATION",
            "city": "St Louis",
            "state": "MO",
            "postal_code": "631418261",
            "country_code": "US",
            "telephone_number": "314-251-6440 x20860",
            "fax_number": "314-251-4456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SRIVASTAVA",
        "first_name": "ANIL",
        "middle_name": "KUMAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2023-03-07",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-090872",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "MO",
            "license": "2004034166",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "MO",
            "license": "2004034166",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2004034166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "927594382",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1205920220",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "2004034166",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "12266 De Paul Dr Ste 305",
            "city": "Bridgeton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630442514",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "asrivastava2731@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "asrivastava2731@direct-ehr-ssmhc.com",
            "address_1": "12266 De Paul Dr Ste 305",
            "city": "Bridgeton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630442514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cynthia D. Spence
• Craig A Spiegel, M.D.
• Fradi Spilberg, PH.D.
• Michelle Spond
• Katherine Louise Sprock, RD LD
• SSM Cardiovascular and Thoracic Services, Inc.
• SSM Depaul Health Center
• SSM Depaul Health Center Foundation
• SSM Depaul Medical Group (SSM Orthopedics)
• SSM Depaul Medical Group, Inc. (Family Medicine at DePaul)

• Surgery Physician in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.