Avinash Manickam Sridhar, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2016-02308 Issued in NC

Practice address

1215 Lee St
Charlottesville, VA 22908-0816

Phone

(434) 243-7778

NPI assigned

Mar 25, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC, VA, DC3 enrollments

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 3

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.

• MGMC, LLC

  • General Practice Physician
  • Washington, DC
  • NPI 1891797148
  Medicare reassignment NPD
• Medstar Medical Group II LLC

  • General Practice Physician
  • White Plains, MD
  • NPI 1407559081
  NPD
• Samg Inc

  • Primary Care Clinic/Center
  • Plymouth Meeting, PA
  • NPI 1760103881
  NPD (past)

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

{
    "created_epoch": "1427241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564617600000",
    "number": "1922492107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 WHITE FAWN DR",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288014126",
            "telephone_number": "508-733-3730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 LEE ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080816",
            "telephone_number": "434-243-7778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRIDHAR",
        "first_name": "AVINASH",
        "middle_name": "MANICKAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-25",
        "last_updated": "2019-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2016-02308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PE-P4DQ1NAN8",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian Thomas Spoelhof, PHARMD
• Carolyn Springett
• Jessica Leigh Springett, PHARMD
• Jody M Sproul, FNP-BC
• Kellen James Squire
• Prakhyath Srikaram, MD
• Nandan Srinivasa
• Selvi Sriranganathan, M.S.
• Madison Sroufe
• Adam St Clair

• Family Medicine Physician in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.