Active NPI
Nandakumar Srinivasan, MD
- Gastroenterology Physician
- Seattle, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- MD60349184
- Practice address
- 1100 9TH Ave
Ms:C3-Gas
Seattle, WA 98101-2756 - Phone
- (206) 223-2319
- Fax
- (206) 341-1188
- NPI assigned
- Feb 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 104821 | MN | |
| Internal Medicine Physician | 207R00000X | 24986 | OK | |
| Gastroenterology Physician | 207RG0100X | 53201 | MN | |
| Gastroenterology Physician | 207RG0100X | MD60349184 | WA | Primary |
Addresses
Primary practice location
1100 9TH Ave
Ms:C3-Gas
Seattle, WA 98101-2756
Mailing address
1100 9TH Ave
Seattle, WA 98101-2756
Phone (206) 515-5811
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235270927 | Medicaid | WA | |
| P00849771 | Other | MN | MEDICARE, RAILROAD |
| ENROLLED | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Gastroenterology
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3333 Riverbend Dr
Springfield, OR 97477-8800
Phone (541) 222-6000
3355 Riverbend Dr
Suite 400
Springfield, OR 97477-8800
Phone (541) 222-2402
3377 Riverbend Dr
Springfield, OR 97477-8800
Phone (541) 222-6000
4010 Aerial Way
Eugene, OR 97402-9757
Phone (613) 272-4978
Hospital & facility affiliations
- Sacred Heart Medical Center - Riverbend
- Peace Harbor Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 124 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 166 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24986 | OK | MD | Internal Medicine Physician |
| MD60349184 | WA | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peacehealth Medical Group | Internal Medicine | Current | Accepting new patients |
Locations
4010 Aerial Way
Eugene, OR 97402
Phone (541) 242-8300
1115 SE 164th Ave
Dept 358
Vancouver, WA 98683
Phone (360) 729-1253
Interoperability endpoints
- nsrinivasan62877@direct.peacehealth.org
Organizations & group practices 1
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 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Springfield, OR
- NPI 1083888515
-
- Psychiatric Hospital Unit
- Eugene, OR
- NPI 1568236974
-
- Critical Access Hospital
- Florence, OR
- NPI 1578552402
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373932800000",
"number": "1235270927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 9TH AVE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981012756",
"telephone_number": "206-515-5811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 9TH AVE",
"address_2": "MS:C3-GAS",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981012756",
"telephone_number": "206-223-2319",
"fax_number": "206-341-1188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SRINIVASAN",
"first_name": "NANDAKUMAR",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-08",
"last_updated": "2013-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "MN",
"license": "104821",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OK",
"license": "24986",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "MN",
"license": "53201",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "WA",
"license": "MD60349184",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1235270927",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE, RAILROAD",
"identifier": "P00849771",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ENROLLED",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2013; 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.