Individual provider Active NPI

Thiru Mandyam Annaswamy, M.D., M.A.

  • Physical Medicine & Rehabilitation Physician
  • Hummelstown, PA
National Provider Identifier
1083635353
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
MD477514 Issued in PA
Practice address
1135 Olde W Chocolate Ave Ste 101
Hummelstown, PA 17036-9188
Phone
(717) 531-7010
Fax
(717) 531-7102
NPI assigned
Jul 22, 2006
Last updated
Feb 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X K7977 TX
Physical Medicine & Rehabilitation Physician 208100000X MD477514 PA Primary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X K7977 TX
Pain Medicine Physician 208VP0000X MD477514 PA
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician 2081N0008X MD477514 PA
Electrodiagnostic Medicine Physician 204R00000X MD477514 PA

Addresses

Primary practice location

1135 Olde W Chocolate Ave Ste 101
Hummelstown, PA 17036-9188

Mailing address

PO Box 850
Hershey, PA 17033-0850
Phone (717) 531-4263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20101006001107 TX Practitioner - Physical Medicine and Rehabilitation 2466644695 Reassigns benefits to 1 organization
I20220916001344 PA Practitioner - Physical Medicine and Rehabilitation 2466644695 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1135 Olde W Chocolate Ave
Suite 101
Hummelstown, PA 17036-9188
Phone (717) 531-7010

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.36 of 100Reported as group
Quality
56.69
Promoting interoperability
100
Improvement activities
40
Cost
74.52

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K7977TXMDPain Medicine (Physical Medicine & Rehabilitation) Physician
MD477514PAMDPain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Milton S Hershey Medical Center Physician Group CurrentSince Sep 1, 2022 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jun 20, 2010 Accepting new patients
The Milton S Hershey Medical Center Physicians Group Physical Medicine & Rehabilitation CurrentSince Sep 1, 2022 Accepting new patients
The Milton S Hershey Medical Center Physicians Group Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas Physical Medicine & Rehabilitation CurrentSince Jun 20, 2010 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
The Milton S. Hershey Medical Center Physicians Group Past Accepting new patients

Locations

500 University Dr
#410
Hershey, PA 17033
Phone (717) 531-1159

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

1135 Olde W Chocolate Ave
#101
Hummelstown, PA 17036
Phone (717) 531-7010

4500 S Lancaster Rd
#117
Dallas, TX 75216
Phone (214) 857-0819

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

2655 Villa Creek Dr
Farmers Branch, TX 75234
Phone (214) 736-8376

Organizations & group practices 7

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 1

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": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1083635353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170330850",
            "telephone_number": "717-531-4263",
            "fax_number": "717-566-8202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 OLDE W CHOCOLATE AVE STE 101",
            "city": "HUMMELSTOWN",
            "state": "PA",
            "postal_code": "170369188",
            "telephone_number": "717-531-7010",
            "fax_number": "717-531-7102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANNASWAMY",
        "first_name": "THIRU",
        "middle_name": "MANDYAM",
        "name_prefix": "Dr.",
        "credential": "M.D., M.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "K7977",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "MD477514",
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "TX",
            "license": "K7977",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "PA",
            "license": "MD477514",
            "primary": false
        },
        {
            "code": "2081N0008X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Neuromuscular Medicine",
            "state": "PA",
            "license": "MD477514",
            "primary": false
        },
        {
            "code": "204R00000X",
            "taxonomy_group": "",
            "desc": "Electrodiagnostic Medicine",
            "state": "PA",
            "license": "MD477514",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hummelstown, PA

Sources for this page

Verify at the official NPI Registry.