Individual provider Active NPI

Premkumar Nattanmai Chandrasekaran, MD

  • Neurocritical Care Physician
  • Columbia, MO
National Provider Identifier
1063642650
Registry record updated Aug 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurocritical Care PhysicianTaxonomy code 2084A2900X
License
2015002382 Issued in MO
Practice address
One Hospital Dr
Columbia, MO 65212
Phone
(573) 882-1515
Fax
(573) 884-0070
NPI assigned
Jul 17, 2009
Last updated
Aug 9, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 2015002382 MO
Neurocritical Care Physician 2084A2900X 2015002382 MO Primary

Addresses

Primary practice location

One Hospital Dr
Columbia, MO 65212

Mailing address

PO Box 843966
Kansas City, MO 64184-3966
Phone (573) 884-3300

Other practice location 1

One Hospital Dr
Columbia, MO 65212
Phone (573) 882-1515

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150713000930 MO Practitioner - Critical Care (Intensivists)Practitioner - Neurology 5395057871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Neurology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Hospital Dr
Columbia, MO 65212-0001
Phone (573) 882-4141

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.23 of 100Reported as group
Quality
58.17
Promoting interoperability
100
Improvement activities
40
Cost
75.92

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2015002382MOMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Curators of the University of Missouri CurrentSince Jul 1, 2015 Accepting new patients
Curators of the University of Missouri CurrentSince Jul 1, 2015 Accepting new patients

Locations

1 Hospital Dr
Columbia, MO 65212
Phone (573) 882-2568

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1247788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1063642650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843966",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641843966",
            "telephone_number": "573-884-3300",
            "fax_number": "573-884-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE HOSPITAL DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "65212",
            "telephone_number": "573-882-1515",
            "fax_number": "573-884-0070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "One Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "65212",
            "country_code": "US",
            "telephone_number": "573-882-1515",
            "fax_number": "573-884-0070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NATTANMAI CHANDRASEKARAN",
        "first_name": "PREMKUMAR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-17",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "2015002382",
            "primary": false
        },
        {
            "code": "2084A2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "MO",
            "license": "2015002382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.