DR. PAVANA SREENIVASAN M.D.
NPI 1669905113
Pediatrics - Pediatric Critical Care Medicine in Peoria, IL

Q: What is Pavana Sreenivasan's NPI number?

The NPI number for Pavana Sreenivasan is 1669905113. It was assigned to this individual provider in the NPPES registry on April 11, 2017.

Q: What is Pavana Sreenivasan's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Critical Care Medicine, with taxonomy code 2080P0203X.

Active since April 11, 2017PECOS Enrolled

530 NE GLEN OAK AVE, PEORIA, IL 61637(309) 624-0716 Get Directions Write a Review

NPPES record last updated: September 13, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 15, 2020, Sep 11, 2017, Apr 11, 2017 (3 updates tracked since 2017).

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About Dr. Pavana Sreenivasan M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. PAVANA SREENIVASAN M.D. (NPI 1669905113) is an individual pediatric critical care medicine provider in Peoria, Illinois, licensed in Illinois (036.164817) and active in the NPI registry since April 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1669905113

Entity TypeIndividualFemale

Primary Taxonomy2080P0203X

Provider Legal NameDR. PAVANA SREENIVASANCredential: M.D.

Location Address530 NE GLEN OAK AVEPeoria, IL 61637-0001

Mailing Address1201 W La Veta AveOrange, CA 92868-4203

Phone(309) 624-0716

Sole ProprietorNo

Enumeration DateApril 11, 2017

Last NPPES UpdateSeptember 13, 20233 updates tracked since enumeration

NPPES CertifiedSeptember 12, 2023

✔ NPI 1669905113 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric Critical Care MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080P0203X

License✔ Licensed in IL · 036.164817

Definition

A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

530 NE GLEN OAK AVE, Peoria, IL 61637

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Pavana Sreenivasan M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MISS CARA L PHILLIPS PHARMD

Pharmacist