Individual provider Active NPI

Akanksha Srivastava, BDS, MSC, MDSC

  • Oral and Maxillofacial Surgery (Dentist)
  • Chicago, IL
National Provider Identifier
1922483890
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
019033123 Issued in IL
Practice address
811 S Paulina St
Chicago, IL 60612-4353
Phone
(312) 996-9158
NPI assigned
Jul 21, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 019.033123 IL
Prosthodontics 1223P0700X 34819 TX
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 019033123 IL Primary

Addresses

Primary practice location

811 S Paulina St
Chicago, IL 60612-4353

Mailing address

811 S Paulina St
Chicago, IL 60612-4353
Phone (312) 996-7546

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220202002080 IL Practitioner - Dentist 8325343411 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Board of Trustees of the University of IllinoisGroup PAC ID 3072422716, 1,134 clinicians

Practice addresses (Care Compare)

811 S Paulina St
MC 588
Chicago, IL 60612-4353
Phone (312) 996-7745

Hospital & facility affiliations

  • University of Illinois Hospital and Clinics Hospital, Chicago, IL, CCN 140150
  • Rush University Medical Center Hospital, Chicago, IL, CCN 140119

Merit-based Incentive Payment System (MIPS)

Final score
93.28 of 100Reported as group
Quality
73.53
Promoting interoperability
100
Improvement activities
40
Cost
70.73

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.033123ILMDProsthodontist
019033123ILMDOral and Maxillofacial Surgery (Dentist)
34819TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County CurrentSince Mar 7, 2024 Accepting new patients
Cook County CurrentSince Mar 7, 2024 Accepting new patients
Cook County Current Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Board of Trustees Fo the University of Illinois Oral and Maxillofacial Surgery CurrentSince Mar 10, 2022 Accepting new patients
Board of Trustees of the University of Illinois Past Accepting new patients

Locations

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

Interoperability endpoints

  • Direct secure messaging: asrivastava118583@uihealth.direct-ci.com

Organizations & group practices 6

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 3

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": "1437436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1922483890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 S PAULINA ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124353",
            "telephone_number": "312-996-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 S PAULINA ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124353",
            "telephone_number": "312-996-9158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRIVASTAVA",
        "first_name": "AKANKSHA",
        "name_prefix": "Dr.",
        "credential": "BDS, MSC, MDSC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-21",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "IL",
            "license": "019.033123",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "TX",
            "license": "34819",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "019033123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.