Marie Srinivasan, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

12543 Issued in MN

Practice address

4300 Marketpointe Dr Ste 100
Bloomington, MN 55435

Phone

(952) 835-9880

Fax

(952) 857-1554

NPI assigned

Oct 10, 2017

Last updated

Jun 26, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peacehealth Networks on Demand LLCGroup PAC ID 1759731383, 197 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/30646/brand/1/csg/1/fhir/r4
• Direct secure messaging: marie.srinivasan.1@30646.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Peacehealth Networks on Demand, LLC

  dba Zoom Management

  • General Practice Physician
  • Tigard, OR
  • NPI 1023582178

  WA

  Medicare reassignment Care Compare group
• Zoomcare PC

  dba ZoomCare

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1689647372
  NPD (past)
• Zoomcare Urgent Care LLC

  • Urgent Care Clinic/Center
  • Lake Oswego, OR
  • NPI 1376225813
  NPD (past)

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

{
    "created_epoch": "1507593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529971200000",
    "number": "1942710579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 MARKETPOINTE DR STE 100",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554355435",
            "telephone_number": "952-835-9880",
            "fax_number": "952-857-1554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 MARKETPOINTE DR STE 100",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "55435",
            "telephone_number": "952-835-9880",
            "fax_number": "952-857-1554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRINIVASAN",
        "first_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-10",
        "last_updated": "2018-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spectrum of Light Inc
• Lisa Lynn Speese
• Ronald H Spiegel, MD
• Carolyn Sporer-Starkey, LMFT
• Lisa Sharon Squire, PH.D., L.P.
• Christine L St George, GNP
• Beth Ann Staab, M.D.
• Stable Services (The Housing Advocates)
• Ashley Stabno
• Elizabeth Lynn Stadler

• Physician Assistant in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2018; 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.