Individual provider Active NPI

Dasarathy Srinivas, M.D.

  • Gastroenterology Physician
  • Slidell, LA
National Provider Identifier
1851324552
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
05745R Issued in LA
Practice address
1051 Gause Blvd Ste 370
Slidell, LA 70458-2998
Phone
(985) 280-4600
Fax
(985) 280-4642
NPI assigned
Jul 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 05745R LA Primary

Addresses

Primary practice location

1051 Gause Blvd Ste 370
Slidell, LA 70458-2998

Mailing address

1051 Gause Blvd Ste 370
Slidell, LA 70458-2998
Phone (985) 280-4600

Other identifiers 1

IdentifierTypeStateIssuer
1323641MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20110126000834 LA Practitioner - Gastroenterology 9638358377 Practice locations: Slidell, LA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
05745RLAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Slidell Memorial Hospital Past Accepting new patients
Gulf Coast Rheumatology PastSince Jul 14, 2011 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GDBCBD

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1851324552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 GAUSE BLVD STE 370",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704582998",
            "telephone_number": "985-280-4600",
            "fax_number": "985-280-4642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 GAUSE BLVD STE 370",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704582998",
            "telephone_number": "985-280-4600",
            "fax_number": "985-280-4642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRINIVAS",
        "first_name": "DASARATHY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "LA",
            "license": "05745R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1323641",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

Verify at the official NPI Registry.