Puja Srivastava, MD

Primary specialty

Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X

License

35.128078 Issued in OH

Practice address

485 W Main St
Wilmington, OH 45177-2174

Phone

(513) 834-7063

NPI assigned

Jul 5, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Internal Medicine

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

State of Ohio Office of Budget and Management State AccountingGroup PAC ID 0143133181, 109 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• State of Ohio Office of Budget and Management State Accounting

  dba Summit Behavioral Healthcare

  • Psychiatric Hospital
  • Cincinnati, OH
  • NPI 1023082716
  Medicare reassignment Care Compare group NPD
• Brightview, LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Cincinnati, OH
  • NPI 1659769446
  Medicare reassignment NPD
• State of Ohio Office of Budget and Management State Accounting

  dba Ohio Veterans Home

  • Nursing Facility/Intermediate Care Facility
  • Sandusky, OH
  • NPI 1790732576
  NPD
• Brightview LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Asheboro, NC
  • NPI 1962163782
  NPD
• Pinnacle Treatment Centers Oh-VI, LLC

  dba Covedale Treatment Services

  • Methadone Clinic
  • Cincinnati, OH
  • NPI 1043726797
  NPD (past)

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

{
    "created_epoch": "1309824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1699062257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 ELSINORE PL STE 200",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452021457",
            "telephone_number": "513-834-7063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 W MAIN ST",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451772174",
            "telephone_number": "513-834-7063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "375 Dixmyth Ave",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452202475",
            "country_code": "US",
            "telephone_number": "513-862-1400",
            "fax_number": "513-862-4980",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "446 Morgan St",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452062348",
            "country_code": "US",
            "telephone_number": "513-834-7063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SRIVASTAVA",
        "first_name": "PUJA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-05",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.128078",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "OH",
            "license": "35.128078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southwest Inpatient Physicians, LLC
• Southwestern Ohio Urology Inc
• Madison Spangler
• Shyla Kayann Sparks
• Kimberly Dawn Speaks, RN
• Bruce Edmund Staley, MD
• Juliane Stanton, PA-C
• James Craig Strafford, M.D.
• Rebecca E Strauss-Sweet, PT
• Steven Streibick

• Addiction Medicine (Internal Medicine) Physician in Wilmington, OH
• Providers in Wilmington, OH by specialty
• Addiction Medicine (Internal Medicine) Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; 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.