Individual provider Active NPI

Vijay Srinivasan, M.D.

  • Pediatric Critical Care Medicine Physician
  • Atlanta, GA
National Provider Identifier
1275649154
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
97784 Issued in GA
Practice address
2220 N Druid Hills Rd NE
Atlanta, GA 30329-3117
Phone
(404) 785-3975
NPI assigned
Aug 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD073756L PA
Pediatrics Physician 208000000X 97784 GA
Pediatric Critical Care Medicine Physician 2080P0203X MD073756L PA
Pediatric Critical Care Medicine Physician 2080P0203X 97784 GA Primary

Addresses

Primary practice location

2220 N Druid Hills Rd NE
Atlanta, GA 30329-3117

Mailing address

2220 N Druid Hills Rd NE
Atlanta, GA 30329-3117

Other practice location 1

3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Phone (215) 590-1000

Other identifiers 2

IdentifierTypeStateIssuer
1012277730MedicaidPA
089852EMDOtherPAMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050420001171 PA Practitioner - Pediatric MedicinePractitioner - Critical Care (Intensivists) 4789622622 Reassigns benefits to 1 organization
I20240802002404 GA Practitioner - Critical Care (Intensivists) 4789622622 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Choa Hospital Based, LLCGroup PAC ID 4688812498, 97 clinicians

Practice addresses (Care Compare)

1405 Clifton Rd NE
Atlanta, GA 30022-1060
Phone (404) 785-2000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
97784GAMDPediatrics Physician
MD073756LPAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Anesthesiology Associates, LTD Pediatrics CurrentSince Jul 1, 2005 Accepting new patients
Choa Hospital Based, LLC Pediatrics CurrentSince May 20, 2024 Accepting new patients
Children'S Anesthesiology Associates, LTD Pediatrics CurrentSince Jul 1, 2005 Accepting new patients
Children'S Anesthesiology Associates, LTD Current Accepting new patients
Choa Multispecialty, LLC Pediatrics Current Accepting new patients

Locations

1405 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 785-1112

2220 N Druid Hills Rd NE
Brookhaven, GA 30329
Phone (404) 778-1440

3401 Civic Center Blvd
Ste 9329
Philadelphia, PA 19104
Phone (267) 425-9300

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

100 E Penn Sq
Bldg 9TH
Philadelphia, PA 19107
Phone (267) 425-9538

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1275649154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 N DRUID HILLS RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303293117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 N DRUID HILLS RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303293117",
            "telephone_number": "404-785-3975"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 Civic Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191044319",
            "country_code": "US",
            "telephone_number": "215-590-1000",
            "fax_number": "215-590-4327",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SRINIVASAN",
        "first_name": "VIJAY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD073756L",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "97784",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "PA",
            "license": "MD073756L",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "GA",
            "license": "97784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012277730",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "089852EMD",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.