NPIMap

Individual provider Active NPI

Vinee Srivastava, MD

  • Internal Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1720130628
Registry record updated Jul 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35930 Issued in AZ
Practice address
3411 N 5TH Ave., Ste 209
Regional Admin Office
Phoenix, AZ 85013-3812
Phone
(602) 789-0344
Fax
(602) 789-8389
NPI assigned
Jan 18, 2007
Last updated
Jul 10, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35930 AZ Primary

Addresses

Primary practice location

3411 N 5TH Ave., Ste 209
Regional Admin Office
Phoenix, AZ 85013-3812

Mailing address

3411 N 5TH Ave., Ste. 209
Regional Admin Office
Phoenix, AZ 85013-3812
Phone (602) 789-0344

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20070205000682 AZ Practitioner - Internal Medicine 8628070687 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clark Medical and Post-Acute Services LLCGroup PAC ID 5991164402, 6 clinicians

Practice addresses (Care Compare)

10810 N Tatum Blvd
102 107
Phoenix, AZ 85028-6055
Phone (602) 568-4362

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35930AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ternion Physician Group, PLLC Internal Medicine CurrentSince May 1, 2023 Accepting new patients
Clark Medical and Post-Acute Services, LLC Internal Medicine CurrentSince Jul 12, 2023 Accepting new patients
Glendale Healthcare Associates LLC Past Accepting new patients
Sun City SNF Healthcare, LLC Past Accepting new patients
Sun City of Cascadia LLC Past Accepting new patients

Locations

4704 W Diana Ave
Glendale, AZ 85302
Phone (623) 247-3949

10810 N Tatum Blvd
#102107
Phoenix, AZ 85028
Phone (602) 568-4362

10810 N Tatum Blvd
Ste 102107
Phoenix, AZ 85028
Phone (602) 568-4362

42104 N Venture Dr
Ste D118
Phoenix, AZ 85086
Phone (623) 505-4479

8008 S Jesse Owens Pkwy
Phoenix, AZ 85042
Phone (602) 243-2780

2401 E Hunt Dr
Show Low, AZ 85901
Phone (928) 537-5333

10601 W Santa Fe Dr
Sun City, AZ 85351
Phone (623) 832-7000

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Osborn Health and RehabilitationScottsdale, AZ, CCN 035076 Skilled nursing facility Operational/Managerial Control
Managing Control - Governing Body
Adp of the SNF		 May 2, 2023
May 2, 2023
May 2, 2023
Boswell Transitional Care of CascadiaSun City, AZ, CCN 035121 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 14, 2022
Jun 30, 2025
Sun City Post AcuteSun City, AZ, CCN 035225 Skilled nursing facility Contracted Managing Employee Nov 1, 2024
Emblem Hospice WestPhoenix, AZ, CCN 031661 Hospice Contracted Managing Employee Sep 5, 2023

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 7

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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531180800000",
    "number": "1720130628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3411 N 5TH AVE., STE. 209",
            "address_2": "REGIONAL ADMIN OFFICE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133812",
            "telephone_number": "602-789-0344",
            "fax_number": "602-789-8389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3411 N 5TH AVE., STE 209",
            "address_2": "REGIONAL ADMIN OFFICE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133812",
            "telephone_number": "602-789-0344",
            "fax_number": "602-789-8389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRIVASTAVA",
        "first_name": "VINEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2018-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "35930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.