Individual provider Active NPI

Raghuraman Srinivasan, M.D.

  • Interventional Cardiology Physician
  • Maysville, KY
National Provider Identifier
1720057862
Registry record updated Oct 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
28708 Issued in KY
Practice address
450A Tucker Dr
Maysville, KY 41056-9110
Phone
(606) 759-0339
Fax
(606) 759-0139
NPI assigned
Mar 14, 2006
Last updated
Oct 24, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2013

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 28708 KY
Cardiovascular Disease Physician 207RC0000X 35077864S OH
Interventional Cardiology Physician 207RI0011X 28708 KY Primary
Interventional Cardiology Physician 207RI0011X 35077864S OH
Nuclear Cardiology Physician 207UN0901X 28708 KY
Nuclear Cardiology Physician 207UN0901X 35077864S OH

Addresses

Primary practice location

450A Tucker Dr
Maysville, KY 41056-9110

Mailing address

450A Tucker Dr
Maysville, KY 41056-9110
Phone (606) 759-0339

Other identifiers 5

IdentifierTypeStateIssuer
64287089MedicaidKY
9321441OtherOHOH MEDICARE GRP #
3810020951MedicaidWV
2144594MedicaidOH
6293OtherKYKY MEDICARE GRP #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20100512001042 KY Practitioner - Cardiovascular Disease (Cardiology) 2062445497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heart Smart PLCGroup PAC ID 4385879287, 2 clinicians

Practice addresses (Care Compare)

450 A Tucker Dr
Maysville, KY 41056-9110
Phone (606) 759-0339

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.22 of 100Reported as individual
Quality
82.1
Improvement activities
40
Cost
65.07

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting67
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35077864SOHMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Valley Heart, P.S.C. Cardiovascular Disease Past Accepting new patients
Parkway Medical Clinic Past Accepting new patients

Organizations & group practices 3

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 5

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382572800000",
    "number": "1720057862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450A TUCKER DR",
            "city": "MAYSVILLE",
            "state": "KY",
            "postal_code": "410569110",
            "telephone_number": "606-759-0339",
            "fax_number": "606-759-0139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450A TUCKER DR",
            "city": "MAYSVILLE",
            "state": "KY",
            "postal_code": "410569110",
            "telephone_number": "606-759-0339",
            "fax_number": "606-759-0139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRINIVASAN",
        "first_name": "RAGHURAMAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2013-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "KY",
            "license": "28708",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35077864S",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "KY",
            "license": "28708",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "OH",
            "license": "35077864S",
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "KY",
            "license": "28708",
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "OH",
            "license": "35077864S",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64287089",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OH MEDICARE GRP #",
            "identifier": "9321441",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810020951",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2144594",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY MEDICARE GRP #",
            "identifier": "6293",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maysville, KY

Sources for this page

Verify at the official NPI Registry.