NPIMap

Individual provider Active NPI

Poornachandran Manikantan, MD

  • Pain Medicine (Anesthesiology) Physician
  • Springfield, MA
National Provider Identifier
1003806308
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
203609 Issued in MA
Practice address
1350 Main St Ste 1300
Springfield, MA 01103-6107
Phone
(413) 796-7494
Fax
(413) 796-7498
NPI assigned
Oct 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 203609 MA
Pain Medicine (Anesthesiology) Physician 207LP2900X 203609 MA Primary

Addresses

Primary practice location

1350 Main St Ste 1300
Springfield, MA 01103-6107

Mailing address

1350 Main St Ste 1300
Springfield, MA 01103-6107
Phone (413) 796-7494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101130000350 MA Practitioner - AnesthesiologyPractitioner - Pain Management 9931261922 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baystate Medical Practices IncGroup PAC ID 5991602971, 1,350 clinicians

Practice addresses (Care Compare)

759 Chestnut St
Springfield, MA 01107-1619
Phone (413) 794-8121

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
203609MAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baystate Medical Practices, Inc CurrentSince Jan 1, 2025 Accepting new patients
Springfield Anesthesia Service, Inc. Anesthesiology CurrentSince Jul 1, 2001 Accepting new patients
Umass Memorial Medical Group Inc Anesthesiology Past Accepting new patients
Hampden County Physician Associates, LLC. PastSince Jan 1, 2025 Accepting new patients

Locations

164 High St
Greenfield, MA 01301
Phone (413) 772-0211

759 Chestnut St
Springfield, MA 01199
Phone (413) 794-3233

908 Allen St
Springfield, MA 01118
Phone (413) 732-5139

759 Chestnut St
Springfield, MA 01107
Phone (413) 794-6297

280 Chestnut St
Fl 2
Springfield, MA 01199
Phone (413) 788-4385

3400 Main St
Springfield, MA 01107
Phone (413) 794-8777

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 7

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": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1003806308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 MAIN ST STE 1300",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011036107",
            "telephone_number": "413-796-7494",
            "fax_number": "413-796-7498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 MAIN ST STE 1300",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011036107",
            "telephone_number": "413-796-7494",
            "fax_number": "413-796-7498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANIKANTAN",
        "first_name": "POORNACHANDRAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "203609",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MA",
            "license": "203609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.