Individual provider Active NPI

Srinivas K. Janardan, M.D.

  • Gastroenterology Physician
  • Grand Rapids, MI
National Provider Identifier
1770588279
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
4301060361 Issued in MI
Practice address
310 Lafayette Ave SE
Ste 400
Grand Rapids, MI 49503-4693
Phone
(616) 752-6525
Fax
(616) 752-6556
NPI assigned
Jun 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 4301060361 MI
Gastroenterology Physician 207RG0100X 4301060361 MI Primary

Addresses

Primary practice location

310 Lafayette Ave SE
Ste 400
Grand Rapids, MI 49503-4693

Mailing address

310 Lafayette Ave SE
Ste 400
Grand Rapids, MI 49503-4693
Phone (616) 752-6525

Other identifiers 1

IdentifierTypeStateIssuer
3256628MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20050910000224 MI Practitioner - Gastroenterology 5597723726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Northwestern University Feinberg Medical School, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10047 Crossroad CT SE
Caledonia, MI 49316-7316
Phone (616) 685-8850

310 Lafayette Ave SE
Grand Rapids, MI 49503-4693

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy43
Upper gastrointestinal (GI) endoscopy for acid reflux20

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301060361MIMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health/Saint Mary'S Medical Group Current Accepting new patients
Grand River Gastroenterology PC Specialist CurrentSince Jul 1, 1996 Accepting new patients
Advantage Health Saint Mary'S Medical Group CurrentSince Mar 1, 2024 Accepting new patients
Advantage Health Saint Mary'S Medical Group CurrentSince Mar 1, 2024 Accepting new patients
Grand River Endoscopy Center, L.L.C. Current Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

310 Lafayette Ave SE
Ste 4
Grand Rapids, MI 49503
Phone (616) 752-6525

310 Lafayette Ave SE
Ste 40
Grand Rapids, MI 49503
Phone (616) 752-6525

310 Lafayette Ave SE
Ste 400
Grand Rapids, MI 49503
Phone (616) 752-6525

Interoperability endpoints

  • Direct secure messaging: sjanardan27399@direct.trinity-health.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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1770588279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 LAFAYETTE AVE SE",
            "address_2": "STE 400",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034693",
            "telephone_number": "616-752-6525",
            "fax_number": "616-752-6556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 LAFAYETTE AVE SE",
            "address_2": "STE 400",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034693",
            "telephone_number": "616-752-6525",
            "fax_number": "616-752-6556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANARDAN",
        "first_name": "SRINIVAS",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "4301060361",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "4301060361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3256628",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.