SANJUKTA SRIDHARAN (M.D.) – Family Medicine Physician, NPI 1083823728
Family Medicine Physician
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Profile Insights
NPPES metrics only — not quality of care.
4,432 FAMILY PRACTICE in MI
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Provider Addresses for SANJUKTA SRIDHARAN (M.D.)
955 POWELL AVE SW
RENTON, WA 980572908
Phone: (425) 277-1311
Fax: (425) 277-1566
Type: Mailing
20311, Mack Avenue, Grosse Pointe Woods, Wayne County, Michigan, 48236, United States
GROSSE POINTE WOODS, MI 482361784
Phone: (313) 499-6000
Type: Mailing
26401 PACIFIC HWY S STE 101
DES MOINES, WA 981989247
Phone: (206) 870-3590
Fax: (206) 824-1670
Type: Location
15777 Northline Rd Ste 202
Southgate, MI 481952354
Phone: (734) 246-8100
Fax: (734) 324-9527
Type: Location
20311 Mack Ave
Grosse Pointe Woods, MI 482361784
Phone: (248) 499-6000
Type: Location
126 AUBURN AVE STE 300
AUBURN, WA 980025082
Phone: (253) 735-0166
Fax: (253) 253-3222
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-11-19
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20100225000121 | I | Family Practice | MI | TBD |
| I20251119003406 | I | Family Practice | WA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 64 | 46 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 22 | 22 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 13 | 13 | $0 |
Insurance plans in this area (ZIP 98057)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MI | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | MI | |
| Internal Medicine | MI | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | MI | |
| Physician Assistant | MI |
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