Sasikumar Vishwanath, M.D.
Individual provider Active NPI Internal Medicine Physician · Florala, AL
NPI 1013016732 · NPPES record last updated Nov 4, 2011
Key facts
- NPI
- 1013016732
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 19896 (AL)
- Practice address
- 1073 3Rd St
Florala, AL 36442-3231 - Phone
- (334) 858-2050
- Fax
- (334) 858-2120
- NPI assigned
- Sep 21, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Hospital & facility affiliations 9
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1073 3Rd St
Florala, AL 36442-3231
Phone (334) 858-2050
PO Box
Suite 505
Florala, AL 36442
Hospital & facility affiliations
- Centerwell Home Health
- LHC Homecare of South Alabama
- Aveanna Hospice of Andalusia
- Andalusia Health
- Mizell Memorial Hospital
- North Okaloosa Medical Center
- Medical Center Enterprise
- HCA Florida Twin Cities Hospital
- Florala Health and Rehabilitation LLC
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 1-10 |
| Removal or shaving of skin growth | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070927000181 | AL | Practitioner - Internal Medicine | 6103880505 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19896 | AL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| S.Vishwanath MD PC | Internal Medicine | Current |
Accepting new patients |
| Florala Health and Rehabilitation, LLC | Past | Accepting new patients |
Locations
24245 5th Ave
Florala, AL 36442
Phone (334) 858-2050
1073 3rd St
Florala, AL 36442
Phone (334) 858-2050
Interoperability endpoints
- vishwanath@svishwanath.direct.emds.com
- https://fhir-usa.unify.chbase.com/org/mizell-be98b63e
- https://fhir.yourcareuniverse.net/tenant/dfc490e3-ba4d-46f6-a3af-71c1dcca8d5c
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 19896 | AL | Yes |
Addresses
Primary practice location
1073 3Rd St
Florala, AL 36442-3231
Mailing address
1073 3Rd St
Florala, AL 36442-3231
Phone (334) 858-2050
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003815600 | Medicaid | FL | |
| 110173224 | Other | AL | RAILROADMEDICARE |
| 51037033VIS | Other | AL | UNITED HEALTHCARE |
| 51037033VIS | Other | FL | BLUECROSS OF FLORIDA |
| 103596 | Medicaid | AL | |
| 51037033VIS | Other | AL | AETNA |
| 51037033VIS | Other | AL | HUMANA |
| P00410027 | Other | AL | RAILROAD MEDICARE |
| 51524095 | Other | AL | BLUCROSS OF ALABAMA |
| 251015400 | Medicaid | FL |
NPI Registry JSON
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320364800000",
"number": "1013016732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1073 3RD ST",
"city": "FLORALA",
"state": "AL",
"postal_code": "364423231",
"telephone_number": "334-858-2050",
"fax_number": "334-858-2120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1073 3RD ST",
"city": "FLORALA",
"state": "AL",
"postal_code": "364423231",
"telephone_number": "334-858-2050",
"fax_number": "334-858-2120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VISHWANATH",
"first_name": "SASIKUMAR",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-21",
"last_updated": "2011-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AL",
"license": "19896",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003815600",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROADMEDICARE",
"identifier": "110173224",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "51037033VIS",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS OF FLORIDA",
"identifier": "51037033VIS",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "103596",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "51037033VIS",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "51037033VIS",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00410027",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUCROSS OF ALABAMA",
"identifier": "51524095",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "251015400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Florala, AL
- Lauren Hose Tatum
- United Florala Inc.
- United Florala Inc.
- United Florala Inc.
- United Florala, Inc
- Judy Louise White
All providers in Florala, AL · Internal Medicine Physician in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.