Individual provider Active NPI

Srinivas Koya, MD

  • Hospitalist Physician
  • Matthews, NC
National Provider Identifier
1376650010
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
2015-01445 Issued in NC
Practice address
1500 Matthews Township Pkwy
Matthews, NC 28105-4656
Phone
(704) 384-9740
Fax
(704) 384-9565
NPI assigned
Aug 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD0000039260 TN
Internal Medicine Physician 207R00000X 01049606A IN
Hospitalist Physician 208M00000X 2015-01445 NC Primary

Addresses

Primary practice location

1500 Matthews Township Pkwy
Matthews, NC 28105-4656

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-9740

Other practice location 1

4801 E Linwood Blvd
Kansas City, MO 64128-2226
Phone (816) 861-4700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address skoya248713@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20151013001451 NC Practitioner - HospitalistPractitioner - Internal Medicine 6204008600 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

1500 Matthews Township Pkwy
Matthews, NC 28105-4656
Phone (704) 384-5416

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01049606AINMDInternal Medicine Physician
MD0000039260TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Internal Medicine CurrentSince Apr 22, 2023 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Apr 22, 2023 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Matthews Medical Center LLC CurrentSince Jan 22, 2024 Accepting new patients
Saint Lukes Physician Group II LLC Hospitalist Past Accepting new patients
Kelly Medical Services Corporation LLC Internal Medicine Past Accepting new patients

Locations

1901 Randolph Rd
Charlotte, NC 28207
Phone (704) 316-2000

1500 Matthews Township Pkwy
Matthews, NC 28105
Phone (704) 384-6500

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: skoya248713@direct.novanthealth.org

Organizations & group practices 6

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 5

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1376650010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-9740",
            "fax_number": "704-384-9565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 MATTHEWS TOWNSHIP PKWY",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281054656",
            "telephone_number": "704-384-9740",
            "fax_number": "704-384-9565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4801 E Linwood Blvd",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641282226",
            "country_code": "US",
            "telephone_number": "816-861-4700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOYA",
        "first_name": "SRINIVAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2020-10-28",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD0000039260",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01049606A",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "2015-01445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "skoya248713@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "4801 E Linwood Blvd",
            "city": "Kansas City",
            "state": "MO",
            "country_code": "US",
            "postal_code": "641282226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Matthews, NC

Sources for this page

Verify at the official NPI Registry.