Individual provider Active NPI

Pooja Srivastava, DPM

  • Foot & Ankle Surgery Podiatrist
  • Farmington Hills, MI
National Provider Identifier
1306409131
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
5901400424 Issued in MI
Practice address
21111 Middlebelt Rd
Farmington Hills, MI 48336-5549
Phone
(248) 478-1150
NPI assigned
Apr 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 5901400424 MI Primary

Addresses

Primary practice location

21111 Middlebelt Rd
Farmington Hills, MI 48336-5549

Mailing address

21111 Middlebelt Rd
Farmington Hills, MI 48336-5549
Phone (248) 478-1150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220614002015 MI Practitioner - Podiatry 4284960303 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5901400424MIMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Foot Specialists PC CurrentSince Aug 1, 2022 Accepting new patients
Foot Specialists PC Foot & Ankle Surgery CurrentSince Aug 1, 2022 Accepting new patients

Locations

21111 Middlebelt Rd
Farmington Hills, MI 48336
Phone (248) 478-1150

11650 Belleville Rd
Van Buren Township, MI 48111
Phone (734) 325-2443

Organizations & group practices 3

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": "1555459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1306409131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21111 MIDDLEBELT RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483365549",
            "telephone_number": "248-478-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21111 MIDDLEBELT RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483365549",
            "telephone_number": "248-478-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRIVASTAVA",
        "first_name": "POOJA",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-17",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901400424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.