Individual provider Active NPI

Kumarasamy Sivakumar, MD

  • Internal Medicine Physician
  • Lancaster, CA
National Provider Identifier
1083762884
Registry record updated Mar 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A54211 Issued in CA
Practice address
44215 15TH St W
Suite # 307
Lancaster, CA 93534-4014
Phone
(661) 949-5908
Fax
(661) 949-5594
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A54211 CA Primary

Addresses

Primary practice location

44215 15TH St W
Suite # 307
Lancaster, CA 93534-4014

Mailing address

43723 20TH W St 203
Lancaster, CA 93534-4784
Phone (661) 941-4958

Other identifiers 1

IdentifierTypeStateIssuer
00A542110MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A54211CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kumarasamy Sivakumar M.D. ,Inc. Internal Medicine Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15728/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490832000000",
    "number": "1083762884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43723 20TH W ST 203",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935344784",
            "telephone_number": "661-941-4958",
            "fax_number": "661-941-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44215 15TH ST W",
            "address_2": "SUITE # 307",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935344014",
            "telephone_number": "661-949-5908",
            "fax_number": "661-949-5594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIVAKUMAR",
        "first_name": "KUMARASAMY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2017-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A54211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A542110",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2017; 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.