Active NPI
Sanket Srinivasa, MD
- Surgery Physician
- Saint Louis, MO
National Provider Identifier
1649825902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 2019011878
- Practice address
- 4921 Parkview PL Ste 8C
Saint Louis, MO 63110-1032 - Phone
- (314) 747-0410
- NPI assigned
- Aug 5, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 2019011878 | MO | Primary |
Addresses
Primary practice location
4921 Parkview PL Ste 8C
Saint Louis, MO 63110-1032
Mailing address
660 S Euclid Ave
Campus Box 8109
Saint Louis, MO 63110
Phone (314) 747-0410
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2019011878 | MO | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564963200000",
"number": "1649825902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "660 S EUCLID AVE",
"address_2": "CAMPUS BOX 8109",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "63110",
"telephone_number": "314-747-0410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4921 PARKVIEW PL STE 8C",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101032",
"telephone_number": "314-747-0410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SRINIVASA",
"first_name": "SANKET",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-08-05",
"last_updated": "2019-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MO",
"license": "2019011878",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.