Individual provider Active NPI

Vijay Shanmugam, M.D.

  • Neurology Physician
  • Lancaster, CA
National Provider Identifier
1174576839
Registry record updated Mar 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
A66787 Issued in CA
Practice address
44215 15TH St W
#204
Lancaster, CA 93534-4014
Phone
(661) 726-9220
Fax
(661) 726-0240
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X A66787 CA Primary

Addresses

Primary practice location

44215 15TH St W
#204
Lancaster, CA 93534-4014

Mailing address

44215 15TH St W
#204
Lancaster, CA 93534-4014
Phone (661) 726-9220

Other identifiers 1

IdentifierTypeStateIssuer
00A667870MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20080303000314 CA Practitioner - Neurology 7012997778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1976
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Vijay Shanmugam M D IncGroup PAC ID 2163737032, 2 clinicians

Practice addresses (Care Compare)

44215 15TH St W
Suite 204
Lancaster, CA 93534-5504

Hospital & facility affiliations

  • Sunny Life Home Health Care Inc Home health agency, Glendale, CA, CCN 753188
  • Antelope Valley Hospital Hospital, Lancaster, CA, CCN 050056
  • Ridgecrest Regional Hospital Hospital, Ridgecrest, CA, CCN 051333
  • Palmdale Regional Medical Center Hospital, Palmdale, CA, CCN 050204

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
93.33
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A66787CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lancaster Hospital Corporation Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: shanmugam.vijay.003.0050492@shvi.meditab.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301270400000",
    "number": "1174576839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44215 15TH ST W",
            "address_2": "#204",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935344014",
            "telephone_number": "661-726-9220",
            "fax_number": "661-726-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44215 15TH ST W",
            "address_2": "#204",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935344014",
            "telephone_number": "661-726-9220",
            "fax_number": "661-726-0240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANMUGAM",
        "first_name": "VIJAY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2011-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A66787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A667870",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.