NPIMap

Individual provider Active NPI

Balaji Srinivasan, MD

  • Nephrology Physician
  • La Crosse, WI
National Provider Identifier
1467456244
Registry record updated Feb 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
43728 Issued in WI
Practice address
1836 South Ave
La Crosse, WI 54601-5429
Phone
(608) 782-7300
NPI assigned
Jun 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 43728 WI Primary
Nephrology Physician 207RN0300X 35599 IA

Addresses

Primary practice location

1836 South Ave
La Crosse, WI 54601-5429

Mailing address

1836 South Ave
La Crosse, WI 54601-5429
Phone (608) 782-7300

Other identifiers 1

IdentifierTypeStateIssuer
34563900MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040929000895 WI Practitioner - NephrologyPractitioner - Internal Medicine 9335118058 Reassigns benefits to 3 organizations
I20041013001409 IA Practitioner - NephrologyPractitioner - Internal Medicine 9335118058 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gundersen Clinic LTDGroup PAC ID 9638082779, 422 clinicians
Gundersen Lutheran Medical Center IncGroup PAC ID 2163331414, 888 clinicians

Practice addresses (Care Compare)

120 2ND Ave SE
Waukon, IA 52172-2073
Phone (563) 568-3000

1836 S Ave
La Crosse, WI 54601-5429
Phone (608) 783-7300

1910 S Ave
La Crosse, WI 54601-5467
Phone (608) 782-7300

2575 S 7TH St
Bethany Riverside
La Crosse, WI 54601-5429
Phone (608) 775-8200

50 N 4TH St
Lansing, IA 52151-7729
Phone (563) 538-4874

Hospital & facility affiliations

  • Gundersen Lutheran Renal Dialysis - Onalaska Dialysis facility, Onalaska, WI, CCN 523528
  • Gundersen Lutheran Renal Dialysis - Viroqua Dialysis facility, Viroqua, WI, CCN 523517
  • Gundersen Lutheran Renal Dialysis - la Crosse Dialysis facility, La Crosse, WI, CCN 522313
  • Gundersen Lutheran Medical Center Hospital, La Crosse, WI, CCN 520087
  • Gundersen Boscobel Area Hospital and Clinics Hospital, Boscobel, WI, CCN 521344
  • Vernon Memorial Hospital Hospital, Viroqua, WI, CCN 521348
  • Gundersen St Josephs Hospital and Clinics Hospital, Hillsboro, WI, CCN 521304
  • Mayo Clinic Health System-Franciscan Medical Center Inc Hospital, La Crosse, WI, CCN 520004

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35599IAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Clinic LTD CurrentSince Aug 11, 2004 Accepting new patients
Memorial Hospital of Boscobel CurrentSince Feb 8, 2023 Accepting new patients
Memorial Hospital of Boscobel CurrentSince Feb 8, 2023 Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Jun 1, 2013 Accepting new patients
Gundersen Lutheran Medical Center Inc CurrentSince Jun 1, 2013 Accepting new patients
Palmer Lutheran Health Center, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Gundersen Lutheran Express Care, Inc CurrentSince Aug 9, 2004 Accepting new patients
Palmer Lutheran Health Center, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Gundersen Lutheran Medical Center Inc Current Accepting new patients
Gundersen Clinic LTD CurrentSince Aug 9, 2004 Accepting new patients
Gundersen Clinic, LTD. Past Accepting new patients
Memorial Hospital of Boscobel Past Accepting new patients

Locations

235 8th Ave W
Cresco, IA 52136
Phone (319) 547-2101

112 Jefferson St
West Union, IA 52175
Phone (563) 422-3811

205 Parker St
Boscobel, WI 53805
Phone (608) 375-4112

402 W Lake St
Friendship, WI 53934
Phone (608) 339-3331

1910 South Ave
La Crosse, WI 54601
Phone (608) 775-2287

1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102

1600 Main St
Onalaska, WI 54650
Phone (608) 783-4681

610 E Taylor St
Prairie du Chien, WI 53821
Phone (608) 326-6466

407 S Main St
Ste 200
Viroqua, WI 54665
Phone (608) 637-3195

Interoperability endpoints

  • Direct secure messaging: bsrinivasan1938@direct.emplifyhealth.org

Organizations & group practices 12

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454371200000",
    "number": "1467456244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRINIVASAN",
        "first_name": "BALAJI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2016-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WI",
            "license": "43728",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IA",
            "license": "35599",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34563900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.