Active NPI
Srivadee Oravivattanakul, MD
- Neurology Physician
- Allen, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- T1170
- Practice address
- 907 Panther LN
Allen, TX 75013-4879 - Phone
- (612) 423-6261
- NPI assigned
- Oct 1, 2008
- Last updated
- Jan 10, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 01086134A | IN | |
| Neurology Physician | 2084N0400X | ME143886 | FL | |
| Neurology Physician | 2084N0400X | 25MA11151800 | NJ | |
| Neurology Physician | 2084N0400X | 75834-20 | WI | |
| Neurology Physician | 2084N0400X | T1170 | TX | Primary |
Addresses
Primary practice location
907 Panther LN
Allen, TX 75013-4879
Mailing address
907 Panther LN
Allen, TX 75013-4879
Phone (612) 423-6261
Other practice location 1
1701 S Creasy Ln
Lafayette, IN 47905-4972
Phone (765) 502-4400
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | soravivattanakul601017@Direct.FranciscanAlliance.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ, WI, VA, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 4
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
2000 Health Park Dr
Brentwood, TN 37027-4692
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME143886 | FL | MD | Neurology Physician |
| 75834-20 | WI | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Atlanticare Physician Group, PA | Current | Accepting new patients | |
| Bellin Memorial Hospital Inc | Family Medicine | Current | Accepting new patients |
| Atlanticare Physician Group PA | Family Medicine | Current | Accepting new patients |
| Hackensack Meridian Health Medical Group - Specialty Care PC | Current | Accepting new patients | |
| Hackensack Meridian Health Medical Group - Specialty Care PC | Current | Accepting new patients | |
| Bon Secours Medical Group Richmond Specialty Care LLC | Neurology | Current | Accepting new patients |
| The Austin Diagnostic Clinic, PLLC | Current | Accepting new patients | |
| Bellin Memorial Hospital Inc | Family Medicine | Current | Accepting new patients |
| The Austin Diagnostic Clinic, PLLC | Current | Accepting new patients | |
| Bon Secours Medical Group Richmond Specialty Care LLC | Current | Accepting new patients | |
| Neurology Associates of Ormond Beach | Neurology | Current | Accepting new patients |
| Austin Diagnostic Clinic | Current | Accepting new patients | |
| Bellin Memorial Hospital Inc | Family Medicine | Current | Accepting new patients |
| Hospital Authority of the City of Bainbridge and Decatur County | Past | Accepting new patients | |
| The Austin Diagnostic Clinic, PLLC | Past | Accepting new patients | |
| Austin Diagnostic Clinic, PA | Past | Accepting new patients | |
| Ozarks Medical Center | Family Medicine | Past | Accepting new patients |
Locations
8 Mirror Lake Dr
Ste A
Ormond Beach, FL 32174
Phone (386) 673-2500
1925 Pacific Ave
Atlantic City, NJ 08401
Phone (609) 441-8023
733 N Beers St
Holmdel, NJ 07733
Phone (732) 264-8484
459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815
1944 State Route 33
Neptune, NJ 07753
Phone (732) 776-3787
3600 State Route 66
Fl 3
Neptune City, NJ 07753
Phone (732) 807-0463
530 New Brunswick Ave
Perth Amboy, NJ 08861
Phone (732) 324-5007
1 Riverview Plz
Red Bank, NJ 07701
Phone (732) 530-2204
2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426
12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530
1510 N 28th St
Ste 110
Richmond, VA 23223
Phone (804) 545-2304
744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/DGHCCA
- https://fhir4.healow.com/fhir/r4/IHJHBD
- soravivattanakul601017@direct.franciscanalliance.org
- srivadee.oravivattanakul.1@8478.direct.athenahealth.com
- srivadee.oravivattanakul@hca8.eclinicaldirectplus.com
Organizations & group practices 17
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.
-
dba Bellin Health Algoma
- Rural Health Clinic/Center
- Algoma, WI
- NPI 1609838473
Family Medicine
-
- Cardiovascular Disease Physician
- Richmond, VA
- NPI 1477112225
Neurology
-
dba HMHMG Specialty Care
- Surgical Critical Care Physician
- Red Bank, NJ
- NPI 1215989249
-
- Hospitalist Physician
- Austin, TX
- NPI 1972011658
-
dba Austin Diagnostic Clinic
- Nephrology Physician
- Austin, TX
- NPI 1497729685
-
dba Austin Diagnostic Clinic
- Urology Physician
- Austin, TX
- NPI 1740255926
-
dba AtlantiCare Urgent Care
- Urgent Care Clinic/Center
- Galloway, NJ
- NPI 1003820622
-
dba Bellin Health
- Family Medicine Physician
- Green Bay, WI
- NPI 1033172390
-
dba Bellin Health Fast Care Manitowoc
- Family Medicine Physician
- Manitowoc, WI
- NPI 1992878730
-
dba Bon Secours Orthopedic Specialists
- Durable Medical Equipment & Medical Supplies
- Midlothian, VA
- NPI 1841029287
-
dba HMMG New Jersey Oral & Maxillofacial Surgery
- Durable Medical Equipment & Medical Supplies
- North Bergen, NJ
- NPI 1215734199
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba North Austin Medical Center
- General Acute Care Hospital
- Austin, TX
- NPI 1629021845
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641772800000",
"number": "1306097084",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "907 PANTHER LN",
"city": "ALLEN",
"state": "TX",
"postal_code": "750134879",
"telephone_number": "612-423-6261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "907 PANTHER LN",
"city": "ALLEN",
"state": "TX",
"postal_code": "750134879",
"telephone_number": "612-423-6261"
}
],
"practiceLocations": [
{
"address_1": "1701 S Creasy Ln",
"address_purpose": "LOCATION",
"city": "Lafayette",
"state": "IN",
"postal_code": "479054972",
"country_code": "US",
"telephone_number": "765-502-4400",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ORAVIVATTANAKUL",
"first_name": "SRIVADEE",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-10-01",
"last_updated": "2022-01-10",
"certification_date": "2022-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "IN",
"license": "01086134A",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "FL",
"license": "ME143886",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NJ",
"license": "25MA11151800",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "WI",
"license": "75834-20",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "TX",
"license": "T1170",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "soravivattanakul601017@Direct.FranciscanAlliance.org",
"affiliation": "N",
"address_1": "1701 S Creasy Ln",
"city": "Lafayette",
"state": "IN",
"country_code": "US",
"postal_code": "479054972",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Allen, TX
- Ndidiamaka Onuorah
- Angela Onyebueze, DNP, APRN, FNP-BC
- Cynthia Chidimma Onyewuche
- Opening New Doors Mental Wellness Counseling
- Optimeyes Optometry, PLLC
- Jacklin Anne Orear
- Original Intent Counseling Center
- Original Intent Counseling Center PLLC
- Ortholonestar, PLLC (Legacy Orthopedics)
- Orthopaedic Associates of North Texas PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; 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.