Prem Srivastava, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

19269801 Issued in NY

Practice address

1 Main St
Roosevelt Island, NY 10044-0052

Phone

(212) 318-4515

NPI assigned

Mar 16, 2007

Sex

Male

Sole proprietor

Yes

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 NY

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

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: psrivastava1175663@nychhc.direct-ci.com

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.

• New York City Health and Hospitals Corporation

  dba Gouverneur Healthcare Services

  • Clinic/Center
  • New York, NY
  • NPI 1548208127

  Internal Medicine

  Medicare reassignment NPD
• New York City Health and Hospitals Corporation

  dba Henry J. Carter Specialty Hospital

  • Clinic/Center
  • New York, NY
  • NPI 1538943469
  NPD
• New York City Health and Hospitals Corporation

  dba Henry J. Carter Skilled Nursing Facility

  • Skilled Nursing Facility
  • New York, NY
  • NPI 1922016781

  Internal Medicine

  NPD
• New York City Health and Hospitals Corporation

  dba Henry J. Carter Specialty Hospital

  • Long Term Care Hospital
  • New York, NY
  • NPI 1992713564

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271030400000",
    "number": "1417081795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 N JERUSALEM RD",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115544741",
            "telephone_number": "516-565-9612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MAIN ST",
            "city": "ROOSEVELT ISLAND",
            "state": "NY",
            "postal_code": "100440052",
            "telephone_number": "212-318-4515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRIVASTAVA",
        "first_name": "PREM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2010-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "19269801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Schuster, MD
• Munir Hussain Shah, M.D.
• Ponnusamy Shanmugham, MD
• Navin K Sharma, M.D.
• Rajiv Shukla, MD
• Yelena Suler, MD
• Alicia Sundar
• Chaitanya Sur, MD
• Gertraud Tejera, MD
• Jaime R. Torres-Figueroa, DPM

• Internal Medicine Physician in Roosevelt Island, NY
• Providers in Roosevelt Island, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2010; 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.