Line Johansen Srinivasan, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

036.131163 Issued in IL

Practice address

800 W Central Rd
Arlington Heights, IL 60005-2349

Phone

(847) 618-1000

NPI assigned

Jun 21, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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

Anesthesiology

Education

Baylor College of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northstar Anesthesia of Illinois, LLCGroup PAC ID 4688893878, 404 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amita Health Resurrection Medical Center Hospital, Chicago, IL, CCN 140117

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Northstar Anesthesia of Illinois, LLC

  • Anesthesiology Physician
  • Arlington, TX
  • NPI 1962822395

  IL

  Medicare reassignment Care Compare group NPD
• Midwest Anesthesia Partners, LLC

  • Anesthesiology Physician
  • Chicago, IL
  • NPI 1255380184
  Medicare reassignment NPD
• Chicago Area Partners in Anesthesia LLC

  • Anesthesiology Physician
  • Naperville, IL
  • NPI 1467770685
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Resurrection Medical Center - Chicago LLC

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1811735228
  Care Compare affiliation

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

{
    "created_epoch": "1245542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412985600000",
    "number": "1780811422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W CENTRAL RD",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W CENTRAL RD",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052349",
            "telephone_number": "847-618-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRINIVASAN",
        "first_name": "LINE",
        "middle_name": "JOHANSEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-21",
        "last_updated": "2014-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "BP10034486",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036.131163",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "60028-20",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780811422",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyra Spiwak, PA-C
• Tracy Lynn Spizzirri, PA-C
• Haley Spolarich, DPT
• Julie Christine Springer, M.D.
• David Anthony Srednick, O.D.
• St Mary Eyecare Inc (Beyond Sight Eyecare)
• Camille N Stackhouse, PA
• Sheila M Stadler, DT
• Robert Vincent Staib, DDS
• Mary Stallons

• Anesthesiology Physician in Arlington Heights, IL
• Providers in Arlington Heights, IL by specialty
• Anesthesiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2014; 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.