Individual provider Active NPI

Dhivya Srinivasa, M.D.

  • Plastic Surgery Physician
  • Agoura Hills, CA
National Provider Identifier
1649596032
Registry record updated Aug 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
A134641 Issued in CA
Practice address
29229 Canwood St Ste 101
Agoura Hills, CA 91301-1503
Phone
(818) 336-1295
NPI assigned
Apr 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X A134641 CA Primary

Addresses

Primary practice location

29229 Canwood St Ste 101
Agoura Hills, CA 91301-1503

Mailing address

5887 Annie Oakley Rd
Hidden Hills, CA 91302-1200
Phone (818) 671-7956

Other practice location 1

2200 Park Bend Dr Ste 200
Austin, TX 78758-5387
Phone (818) 336-1295

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20180711000798 CA Practitioner - General SurgeryPractitioner - Plastic and Reconstructive Surgery 5496062820 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A134641CAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California SFGH Medical Group CurrentSince Jul 1, 2018 Accepting new patients
University of California SFGH Medical Group Plastic Surgery Current Accepting new patients
The Institute for Advanced Breast Reconstruction Inc. Plastic Surgery CurrentSince Jun 2, 2024 Accepting new patients
University of California SFGH Medical Group CurrentSince Jul 1, 2018 Accepting new patients

Locations

1001 Potrero Ave
Rm 3A
San Francisco, CA 94110
Phone (415) 206-4632

415 Rolling Oaks Dr
Ste 220
Thousand Oaks, CA 91361
Phone (805) 379-9696

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1270944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754697600000",
    "number": "1649596032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5887 ANNIE OAKLEY RD",
            "city": "HIDDEN HILLS",
            "state": "CA",
            "postal_code": "913021200",
            "telephone_number": "818-671-7956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29229 CANWOOD ST STE 101",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913011503",
            "telephone_number": "818-336-1295"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 Park Bend Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787585387",
            "country_code": "US",
            "telephone_number": "818-336-1295",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SRINIVASA",
        "first_name": "DHIVYA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-11",
        "last_updated": "2025-08-09",
        "certification_date": "2025-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A134641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Agoura Hills, CA

Sources for this page

Verify at the official NPI Registry.