Madhav K Srivastava, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

36061106 Issued in IL

Practice address

4920 E State St
Rockford, IL 61108-2272

Phone

(815) 226-1906

Fax

(815) 226-8474

NPI assigned

Nov 15, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Madhav Kumar Srivastava Professional name

Medicare fee-for-service enrollment

Enrolled in IL

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

Neurology

Education

Other, 1970

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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.

• DRS. Srivastava S.C.

  • Neurology Physician
  • Rockford, IL
  • NPI 1750434361

  Neurology

  NPD

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316995200000",
    "number": "1770565905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4920 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082272",
            "telephone_number": "815-226-1906",
            "fax_number": "815-226-8474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4920 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082272",
            "telephone_number": "815-226-1906",
            "fax_number": "815-226-8474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRIVASTAVA",
        "first_name": "MADHAV",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2011-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "36061106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RETIRED RAILROAD",
            "identifier": "791133506",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036061106",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "008839",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0010100569",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADHAV",
            "last_name": "SRIVASTAVA",
            "middle_name": "KUMAR",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Manoj Sreedharan, M.D.
• Shylendra B Sreenivasappa, M.D.
• Srivani Sridhar, MD
• Shabarini Srikumar
• Niroashan Srikumaran, MD
• Uma Srivastava, MD
• Lynn Stadtmueller, RPH
• Erin E Staege, M.S., L.P.C.
• Tara Razma Stafford, PA-C
• Margaret Jane Stalder, M.A. CF-SLP

• Neurology Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• Neurology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2011; 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.