Individual provider Active NPI

Shravan Raj Saxena, MD

  • Internal Medicine Physician
  • Albany, NY
National Provider Identifier
1578501623
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
219991 Issued in NY
Practice address
326 S Pearl St
Albany, NY 12202-1914
Phone
(518) 449-0100
Fax
(518) 463-8580
NPI assigned
Jun 2, 2006
Last updated
Jun 17, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 219991 NY Primary

Addresses

Primary practice location

326 S Pearl St
Albany, NY 12202-1914

Mailing address

113 Holland Ave
VA Medical Ctr
Albany, NY 12208
Phone (518) 626-6620

Other identifiers 1

IdentifierTypeStateIssuer
000407996002OtherNYHEALTH NOW - BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20060621000261 NY Practitioner - Internal Medicine 4183636046 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Peter's Hospital of the City of Albany Internal Medicine CurrentSince Feb 1, 2006 Accepting new patients
St. Peter's Hospital of the City of Albany Internal Medicine CurrentSince Feb 1, 2006 Accepting new patients

Locations

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

326 S Pearl St
Albany, NY 12202
Phone (518) 449-0100

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213660800000",
    "number": "1578501623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 HOLLAND AVE",
            "address_2": "VA MEDICAL CTR",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12208",
            "telephone_number": "518-626-6620",
            "fax_number": "518-626-5916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 S PEARL ST",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122021914",
            "telephone_number": "518-449-0100",
            "fax_number": "518-463-8580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAXENA",
        "first_name": "SHRAVAN",
        "middle_name": "RAJ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2008-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "219991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NOW - BLUE SHIELD",
            "identifier": "000407996002",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.