NPIMap

Individual provider Active NPI

Shwetha Sudheendra Shrivatsa, M.D.

  • Gynecology Physician
  • Philadelphia, PA
National Provider Identifier
1699000158
Registry record updated Jan 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
25MA10108100 Issued in NJ
Practice address
4510 Frankford Ave
Philadelphia, PA 19124-3602
Phone
(215) 744-1302
Fax
(215) 744-2544
NPI assigned
Oct 16, 2009
Last updated
Jan 13, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD447014 PA
Gynecology Physician 207VG0400X 25MA10108100 NJ Primary

Addresses

Primary practice location

4510 Frankford Ave
Philadelphia, PA 19124-3602

Mailing address

740 Route 1 N
Iselin, NJ 08830-2652
Phone (732) 362-3840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200130000390 NJ Practitioner - Obstetrics/Gynecology 6800023771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

30 Prospect Ave
Hackensack, NJ 07601-1915

530 New Brunswick Ave
Perth Amboy, NJ 08861-3654
Phone (848) 309-1436

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA10108100NJMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Philadelphia Health Action Inc. CurrentSince Oct 19, 2013 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jan 17, 2023 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jan 17, 2023 Accepting new patients
Greater Philadelphia Health Action, Inc. CurrentSince Oct 19, 2013 Accepting new patients
HMH Hospitals Corporation Past Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

3600 State Route 66
Fl 3
Neptune City, NJ 07753
Phone (732) 807-0463

1 Riverview Plz
Red Bank, NJ 07701
Phone (732) 530-2204

1999 W Hunting Park Ave
Philadelphia, PA 19140
Phone (215) 228-9300

432 N 6th St
Philadelphia, PA 19123
Phone (215) 627-8000

4510 Frankford Ave
Philadelphia, PA 19124
Phone (215) 535-1990

5501 Woodland Ave
Philadelphia, PA 19143
Phone (215) 724-4700

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD
  • Direct secure messaging: shwetha.shrivatsa@direct.hackensackmeridian.org

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 4

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": "1255651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578873600000",
    "number": "1699000158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 ROUTE 1 N",
            "city": "ISELIN",
            "state": "NJ",
            "postal_code": "088302652",
            "telephone_number": "732-362-3840",
            "fax_number": "732-362-3850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 FRANKFORD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191243602",
            "telephone_number": "215-744-1302",
            "fax_number": "215-744-2544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHRIVATSA",
        "first_name": "SHWETHA",
        "middle_name": "SUDHEENDRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-16",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MD447014",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NJ",
            "license": "25MA10108100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.