Individual provider Active NPI

Srijna Nandivada, MD

  • Internal Medicine Physician
  • Dallas, TX
National Provider Identifier
1992117113
Registry record updated Dec 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
R5014 Issued in TX
Practice address
5359 Harry Hines Blvd
8TH FL, Ste HQ08.124
Dallas, TX 75390
Phone
(214) 645-8600
NPI assigned
May 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X BP10050122 TX
Internal Medicine Physician 207R00000X R5014 TX Primary

Addresses

Primary practice location

5359 Harry Hines Blvd
8TH FL, Ste HQ08.124
Dallas, TX 75390

Mailing address

PO Box 845347
Dallas, TX 75284-7208
Phone (214) 645-8600

Other identifiers 1

IdentifierTypeStateIssuer
1992117113OtherNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20171108000929 TX Practitioner - Internal Medicine 6204135403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Texas a & M University System, HSC, College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Texas Southwestern Medical Center at DallasGroup PAC ID 0648188250, 3,156 clinicians

Practice addresses (Care Compare)

6201 Harry Hines Blvd
Dallas, TX 75390-9032
Phone (214) 633-5555

Hospital & facility affiliations

  • Ut of Texas Southwestern University Hospital - William P. Clements Jr. Hospital, Dallas, TX, CCN 450044

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Oct 21, 2019 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Oct 21, 2019 Accepting new patients
Summit Medical Center Past Accepting new patients
University of Texas Southwestern Medical Center at Dallas Internal Medicine Past Accepting new patients

Locations

3450 W Camp Wisdom Rd
Dallas, TX 75237
Phone (214) 214-5820

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

6201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 633-4700

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

Interoperability endpoints

  • Direct secure messaging: srijna.nandivada.1@18564.direct.athenahealth.com

Organizations & group practices 4

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 1

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": "1400716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575849600000",
    "number": "1992117113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752847208",
            "telephone_number": "214-645-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5359 HARRY HINES BLVD",
            "address_2": "8TH FL, STE HQ08.124",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75390",
            "telephone_number": "214-645-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANDIVADA",
        "first_name": "SRIJNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-22",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "BP10050122",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "R5014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1992117113",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.