Individual provider Active NPI

Shuba Srinivasan, PA

  • Physician Assistant
  • Austin, TX
National Provider Identifier
1497702328
Registry record updated Apr 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA03337 Issued in TX
Practice address
901 W 38TH St Ste 200
Austin, TX 78705-1165
Phone
(512) 421-4100
Fax
(512) 454-4575
NPI assigned
May 27, 2006
Last updated
Apr 11, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA03337 TX Primary

Addresses

Primary practice location

901 W 38TH St Ste 200
Austin, TX 78705-1165

Mailing address

PO Box 911230
Dallas, TX 75391-1230
Phone (972) 997-8000

Other identifiers 3

IdentifierTypeStateIssuer
192819402MedicaidTX
192819403MedicaidTX
192819401MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100525000804 TX Practitioner - Physician Assistant 8123157435 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Texas Oncology PAGroup PAC ID 5395658934, 1,001 clinicians

Practice addresses (Care Compare)

12221 Renfert Way
Suite 300
Austin, TX 78758-5453
Phone (512) 873-8900

2026 S Jackson St
Jacksonville, TX 75766-5822
Phone (903) 586-2456

211 Elmhurst
Suite a
Kyle, TX 78640-5983
Phone (512) 268-5383

2410 Round Rock Ave
Suite 150
Round Rock, TX 78681-4019
Phone (512) 341-8724

4101 James Casey St
Austin, TX 78745-1145

7848 Gateway Blvd E
El Paso, TX 79915-1815
Phone (915) 599-1313

901 W 38TH St
Suite 200
Austin, TX 78705-1165
Phone (512) 421-4100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.12 of 100Reported as apm
Quality
67.48
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Austin Diagnostic Clinic, PLLC CurrentSince Jun 15, 2020 Accepting new patients
Texas Oncology PA CurrentSince Dec 18, 2016 Accepting new patients
Texas Oncology PA CurrentSince Dec 18, 2016 Accepting new patients
Texas Oncology PA Past Accepting new patients

Locations

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

12221 Renfert Way
Ste 300
Austin, TX 78758
Phone (512) 873-8900

4315 James Casey St
Austin, TX 78745
Phone (512) 460-3404

901 W 38th St
Ste 200
Austin, TX 78705
Phone (512) 421-4100

7848 Gateway Blvd E
El Paso, TX 79915
Phone (915) 599-1313

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

Interoperability endpoints

  • Direct secure messaging: shuba.srinivasan@txo.ikm.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491868800000",
    "number": "1497702328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 911230",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753911230",
            "telephone_number": "972-997-8000",
            "fax_number": "972-234-0813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W 38TH ST STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051165",
            "telephone_number": "512-421-4100",
            "fax_number": "512-454-4575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRINIVASAN",
        "first_name": "SHUBA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-27",
        "last_updated": "2017-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "192819402",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "192819403",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "192819401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.