Individual provider Active NPI

Priyasha Srivastava, M.D.

  • Internal Medicine Physician
  • Peoria, IL
National Provider Identifier
1417231267
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
125059257 Issued in IL
Practice address
1505 N Peoria Ave
#407
Peoria, IL 61603-3140
Phone
(309) 210-7875
NPI assigned
Sep 28, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 25MA10749000 NJ
Pulmonary Disease Physician 207RP1001X 25MA10749000 NJ
Internal Medicine Physician 207R00000X 25MA10749000 NJ
Internal Medicine Physician 207R00000X 125059257 IL Primary

Addresses

Primary practice location

1505 N Peoria Ave
#407
Peoria, IL 61603-3140

Mailing address

1505 N Peoria Ave
#407
Peoria, IL 61603-3140
Phone (309) 210-7875

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 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
I20150219000550 NY Practitioner - Internal Medicine 4082939830 Reassigns benefits to 1 organization
I20200611000702 NJ Practitioner - Pulmonary Disease 4082939830 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rwjbh Observation Associates LLCGroup PAC ID 5193137503, 995 clinicians
Barnabas Health Medical Group PCGroup PAC ID 9537316955, 1,027 clinicians

Practice addresses (Care Compare)

355 Grand St
Jersey City, NJ 07302-4321
Phone (201) 915-2000

377 Jersey Ave
Suite 280a
Jersey City, NJ 07302-4393
Phone (201) 716-5850

94 Old Short Hills Rd
Livingston, NJ 07039-5672

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
94.87
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
98.51 of 100Reported as apm
Quality
84.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
276883NYMDLicensed Practical Nurse
125059257ILMDInternal Medicine Physician
25MA10749000NJMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Oct 1, 2014 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Mar 10, 2020 Accepting new patients
Westchester Medical Center Advanced Physician Services, PC CurrentSince Oct 1, 2014 Accepting new patients
Rwjbh Observation Associates LLC Internal Medicine CurrentSince Oct 22, 2023 Accepting new patients
Barnabas Health Medical Group PC Internal Medicine CurrentSince Mar 10, 2020 Accepting new patients
Jersey City Medical Center Past Accepting new patients

Locations

1 Clara Maass Dr
Belleville, NJ 07109
Phone (973) 450-2008

355 Grand St
Jersey City, NJ 07302
Phone (201) 915-2224

377 Jersey Ave
Ste 470
Jersey City, NJ 07302
Phone (201) 216-9791

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

3 Executive Dr
Ste 400
Somerset, NJ 08873
Phone (732) 369-5949

110 Rehill Ave
Somerville, NJ 08876
Phone (908) 429-5833

1 Hamilton Health Pl
Trenton, NJ 08690
Phone (609) 584-6763

19 Bradhurst Ave
Ste 3100N
Hawthorne, NY 10532
Phone (914) 231-8373

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

Interoperability endpoints

  • Direct secure messaging: psrivastava46194@epicdirect.rwjbh.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 3

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": "1317168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1417231267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 N PEORIA AVE",
            "address_2": "#407",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033140",
            "telephone_number": "309-210-7875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 N PEORIA AVE",
            "address_2": "#407",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033140",
            "telephone_number": "309-210-7875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRIVASTAVA",
        "first_name": "PRIYASHA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-28",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NJ",
            "license": "25MA10749000",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "25MA10749000",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA10749000",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125059257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.