Ayyasamy P Selvam, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

04-26825 Issued in KS

Practice address

500 N US Highway 89
VA Medical Center
Prescott, AZ 86313-5001

Phone

(928) 776-6009

Fax

(928) 776-6098

NPI assigned

Aug 29, 2006

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 names 1

• Dr. Ayyasamy Panneerselvam Former name

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm

  • Public Health or Welfare Agency
  • Phoenix, AZ
  • NPI 1083643738

  TX

  Medicare reassignment NPD
• Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm

  • Public Health or Welfare Agency
  • Maricopa, AZ
  • NPI 1538043443
  NPD

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1104935832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9080",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863139080",
            "telephone_number": "928-776-6009",
            "fax_number": "928-776-6098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N US HIGHWAY 89",
            "address_2": "VA MEDICAL CENTER",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863135001",
            "telephone_number": "928-776-6009",
            "fax_number": "928-776-6098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELVAM",
        "first_name": "AYYASAMY",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "108004",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "04-26825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AYYASAMY",
            "last_name": "PANNEERSELVAM",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Teri Sebastian, LMFT, LISAC
• Marc M. Sedwitz, M.D.
• Angela Seesholtz, LPC
• George Sein, M.D
• Selah Care, Inc
• Anna Rachel Seno, LCSW
• Serene Life LLC
• Serenity Psychiatric Health Inc.
• Rebecca Marie Serratos
• Servant'S Heart, LLC

• Internal Medicine Physician in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.