Individual provider Active NPI

Raghuram Srinivasan, DO

  • Family Medicine Physician
  • Cincinnati, OH
National Provider Identifier
1255081691
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
011430 Issued in AZ
Practice address
1775 W Lexington Ste 100
Cincinnati, OH 45212-3667
Phone
(513) 977-6700
NPI assigned
Mar 28, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 011430 AZ Primary

Addresses

Primary practice location

1775 W Lexington Ste 100
Cincinnati, OH 45212-3667

Mailing address

407 Race St Apt 1325
Cincinnati, OH 45202-3771

Other practice location 1

5316 E Shea Blvd Ste 100
Scottsdale, AZ 85254-4717
Phone (480) 882-7429

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20250725001779 AZ Practitioner - Family Practice 7012399439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Marian University College of Osteopathic Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Honorhealth Medical Group, LLCGroup PAC ID 1557274057, 338 clinicians

Practice addresses (Care Compare)

5316 E Shea Blvd
Suite 100
Scottsdale, AZ 85254-4717
Phone (480) 882-7420

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Honorhealth Medical Group, LLC Current Accepting new patients
Honorhealth Medical Group, LLC Family Medicine CurrentSince Aug 18, 2025 Accepting new patients
Honorhealth Medical Group, LLC Family Medicine CurrentSince Aug 18, 2025 Accepting new patients
Honorhealth Medical Group, LLC Family Medicine Past Accepting new patients

Locations

10230 W Happy Valley Pkwy
Ste 100C
Peoria, AZ 85383
Phone (623) 561-3030

18404 N Tatum Blvd
Ste 101
Phoenix, AZ 85032
Phone (602) 992-1900

2500 W Utopia Rd
Ste 100
Phoenix, AZ 85027
Phone (623) 683-4462

20745 N Scottsdale Rd
Ste 100
Scottsdale, AZ 85255
Phone (480) 587-5460

5316 E Shea Blvd
Ste 100
Scottsdale, AZ 85254
Phone (480) 882-7410

Interoperability endpoints

  • Direct secure messaging: rsrinivasan636681@direct.honorhealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1255081691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 RACE ST APT 1325",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452023771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 W LEXINGTON STE 100",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452123667",
            "telephone_number": "513-977-6700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5316 E Shea Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852544717",
            "country_code": "US",
            "telephone_number": "480-882-7429",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SRINIVASAN",
        "first_name": "RAGHURAM",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-28",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "011430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.