Ganesh Shanmugam, MD

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

M6388 Issued in TX

Practice address

1602 Rock Prairie Rd
Suite 270
College Station, TX 77845-8306

Phone

(979) 703-6112

Fax

(979) 703-6649

NPI assigned

May 24, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Allergy/Immunology

Education

Texas a & M University System, HSC, College of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• BCS Allergy & Asthma

  • Allergy & Immunology Physician
  • College Station, TX
  • NPI 1396084380
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404086400000",
    "number": "1215148200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 ROCK PRAIRIE RD",
            "address_2": "SUITE 270",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778458306",
            "telephone_number": "979-703-6112",
            "fax_number": "979-703-6649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 ROCK PRAIRIE RD",
            "address_2": "SUITE 270",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778458306",
            "telephone_number": "979-703-6112",
            "fax_number": "979-703-6649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANMUGAM",
        "first_name": "GANESH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2014-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "TX",
            "license": "M6388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3201428",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marc Anthony Serret, M.D.
• Judson Malcome Severson, D.O.
• Rebecca Shanesmith, M.D.
• Aiyanadar Shanmugam, M.D F.A.C.E, F.A.C.E
• Deepal Shanmugam, FNP
• Natraj Aiyappan Shanmugam, M.D.
• Shanna L. Williams DDS, PA
• Nicole Laraye Sharp, LPC
• Elle Shaw
• Roberta Dronen Sheffield, LPC

• Allergy & Immunology Physician in College Station, TX
• Providers in College Station, TX by specialty
• Allergy & Immunology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.