Namun Shanti Srivastava, MD

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

73515 Issued in AZ

Practice address

5310 W Thunderbird Rd Ste 110
Glendale, AZ 85306-4709

Phone

(480) 412-6336

NPI assigned

Jun 20, 2018

Last updated

Aug 12, 2025By 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 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Banner Physician Super Specialists Arizona LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1841573870
  Medicare reassignment NPD
• Banner Physician Super Specialists Arizona LLC

  • Durable Medical Equipment & Medical Supplies
  • Mesa, AZ
  • NPI 1386462810
  NPD

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1275027583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 W THUNDERBIRD RD STE 110",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064709",
            "telephone_number": "480-412-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5310 W THUNDERBIRD RD STE 110",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064709",
            "telephone_number": "480-412-6336"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1432 S Dobson Rd Ste 512",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852024778",
            "country_code": "US",
            "telephone_number": "480-412-6336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SRIVASTAVA",
        "first_name": "NAMUN",
        "middle_name": "SHANTI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-20",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "AZ",
            "license": "73515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sports Medicine Institute Inc
• Katrina M Spradling, FNP-C
• Jasmine Sra, M.D.
• Dharmashree Sreedhar, M.D.
• Srivani Srikantiah, M.D. PLLC
• Husam Srour Mallah, MD
• Ssa Acu Endeavors LLC (Modern Accupuncture)
• Sara Colleen St. John
• Thylma Lynn Sta Maria, MD
• Stacey C. Layman DDS PLLC

• Pediatric Cardiology Physician in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Pediatric Cardiology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.