Muthukumar Vaidyaraman, MD,FIPP, MBA

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

A89024 Issued in CA

Practice address

12040 Darby Ave
Porter Ranch, CA 91326-1112

Phone

(818) 217-4730

NPI assigned

Aug 31, 2006

Last updated

Jan 7, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Business Administration, Doctor of Medicine

Practice roles

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.

• Northridge Pain Management Specialists Medical Corporation

  • Specialist
  • Northridge, CA
  • NPI 1972683555
  NPD (past)
• Millennium Anesthesia PA

  • Anesthesiology Physician
  • Sunrise, FL
  • NPI 1285741322
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294358400000",
    "number": "1003928565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12040 DARBY AVE",
            "city": "PORTER RANCH",
            "state": "CA",
            "postal_code": "913261112",
            "telephone_number": "818-217-4730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12040 DARBY AVE",
            "city": "PORTER RANCH",
            "state": "CA",
            "postal_code": "913261112",
            "telephone_number": "818-217-4730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAIDYARAMAN",
        "first_name": "MUTHUKUMAR",
        "name_prefix": "Dr.",
        "credential": "MD,FIPP, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2011-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME90212",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "A89024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270695400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD",
            "identifier": "ME90212",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Time 2 Talk Speech Therapy, Inc.
• Anita Tipirneni, MD
• Town Center Hospice Care
• Monica Joan Trail, MD.
• Grant Tupinyan
• Jose Jesus Valle, MSW, LCSW
• Valley Presbytarian Hospital
• Nivruthi Vangala, M.D.
• Ani Manukyan Varbedian, LMFT
• Juliette NK Vaspra, MS, RDN

• Interventional Pain Medicine Physician in Porter Ranch, CA
• Providers in Porter Ranch, CA by specialty
• Interventional Pain Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.