NPIMap

Individual provider Active NPI

Pratyaksh Kumar Srivastava, M.D.

  • Cardiovascular Disease Physician
  • Los Angeles, CA
National Provider Identifier
1417319955
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A155100 Issued in CA
Practice address
100 UCLA Medical PLZ Ste 630
Los Angeles, CA 90024-6997
Phone
(310) 825-9011
NPI assigned
Mar 23, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X A155100 CA Primary

Addresses

Primary practice location

100 UCLA Medical PLZ Ste 630
Los Angeles, CA 90024-6997

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Phone (310) 301-8707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230807002311 CA Practitioner - Cardiovascular Disease (Cardiology) 2961756713 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Harvard Medical School, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
San Diego Cardiac Center Medical Group Inc.Group PAC ID 8628045986, 21 clinicians
Emergency and Acute Care Medical CorporationGroup PAC ID 9537108279, 431 clinicians

Practice addresses (Care Compare)

300 S Pierce St
Suite 102
El Cajon, CA 92020-4165
Phone (619) 668-4700

751 Med Ctr CT
Chula Vista, CA 91911-6617
Phone (619) 502-5800

Hospital & facility affiliations

  • Sharp Memorial Hospital Hospital, San Diego, CA, CCN 050100
  • Grossmont Hospital Hospital, La Mesa, CA, CCN 050026
  • Ronald Reagan UCLA Medical Center Hospital, Los Angeles, CA, CCN 050262
  • Sharp Chula Vista Medical Center Hospital, Chula Vista, CA, CCN 050222

Merit-based Incentive Payment System (MIPS)

Final score
87.51 of 100Reported as group
Quality
79.37
Promoting interoperability
100
Improvement activities
40
Cost
73.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A155100CAMDCardiovascular Disease Physician

Practice roles (3 of 4)

OrganizationSpecialtyStatusNew patients
Emergency and Acute Care Medical Corporation CurrentSince Jul 1, 2025 Accepting new patients
Zavaro Cardiovascular Institute, AMC Cardiovascular Disease CurrentSince Jul 1, 2025 Accepting new patients
San Diego Cardiac Center Medical Group Inc Cardiovascular Disease CurrentSince Jul 1, 2025 Accepting new patients

Locations

751 Medical Center Ct
Chula Vista, CA 91911
Phone (619) 482-3639

300 S Pierce St
Ste 102
El Cajon, CA 92020
Phone (619) 668-4700

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

3131 Berger Ave
Ste 200
San Diego, CA 92123
Phone (858) 244-6800

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

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": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1417319955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-8707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 UCLA MEDICAL PLZ STE 630",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900246997",
            "telephone_number": "310-825-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRIVASTAVA",
        "first_name": "PRATYAKSH",
        "middle_name": "KUMAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-23",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A155100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.