Shivi S Siva, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

036138438 Issued in IL

Practice address

600 Northern Blvd Ste 111
Great Neck, NY 11021-5200

Phone

(516) 387-3990

NPI assigned

Sep 30, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Shivi S Sudhagar Former name

Medicare fee-for-service enrollment

Enrolled in IL, NY, PA3 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 3

Specialty

Gastroenterology

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Montefiore New Rochelle HospitalGroup PAC ID 0345474706, 62 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Montefiore New Rochelle Hospital Hospital, New Rochelle, NY, CCN 330184

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: shivisiva@nslijmedgr.allscriptsdirect.net

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.

• Montefiore New Rochelle Hospital

  • General Acute Care Hospital
  • Yonkers, NY
  • NPI 1295163244
  Medicare reassignment Care Compare group NPD
• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment NPD
• Freeport Regional Health Care Foundation

  • Family Medicine Physician
  • Freeport, IL
  • NPI 1457337016
  Medicare reassignment NPD
• Penn State Health Medical Group, LLC

  • Hematology & Oncology Physician
  • Harrisburg, PA
  • NPI 1861988644
  Medicare reassignment NPD
• Physician Services Corporation of Southern Illinois Inc.

  • Internal Medicine Physician
  • Mount Vernon, IL
  • NPI 1831101807
  Medicare reassignment NPD
• North Shore - Lij Medical PC

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1790043479
  NPD
• Penn State Health Medical Group, LLC

  • Diagnostic Radiology Physician
  • Harrisburg, PA
  • NPI 1457824013
  NPD
• Penn State Health Medical Group, LLC

  • Orthopaedic Surgery Physician
  • Reading, PA
  • NPI 1942955521
  NPD

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

• Montefiore New Rochelle Hospital

  • General Acute Care Hospital
  • New Rochelle, NY
  • NPI 1720414154
  Care Compare affiliation

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

{
    "created_epoch": "1380499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1548697964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 NORTHERN BLVD STE 111",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215200",
            "telephone_number": "516-387-3990",
            "fax_number": "309-277-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 NORTHERN BLVD STE 111",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215200",
            "telephone_number": "516-387-3990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "545 Valley View Dr",
            "address_2": "Heartland Clinic, LLC",
            "address_purpose": "LOCATION",
            "city": "Moline",
            "state": "IL",
            "postal_code": "612656138",
            "country_code": "US",
            "telephone_number": "309-762-5560",
            "fax_number": "309-762-1191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIVA",
        "first_name": "SHIVI",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-30",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IN",
            "license": "11017474A",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036138438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036138438",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHIVI",
            "last_name": "SUDHAGAR",
            "middle_name": "S",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Robinder Singh, M.D.
• Sundeep Kaur Singh, PA
• Elissa Joy Siony, PSY.D.
• Waiping Sip, L.AC
• Seblewengal Sirage
• Jessica Lynne Skemer, SLP
• Judy Skibola, PTA
• Sklansky Medical
• Bernard Donald Sklansky, MD
• Aren Hovie Skolnick, D.O.

• Gastroenterology Physician in Great Neck, NY
• Providers in Great Neck, NY by specialty
• Gastroenterology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.