Individual provider Active NPI

Mirabai Chockalingam, M.D.

  • Internal Medicine Physician
  • Fairport, NY
National Provider Identifier
1245263318
Registry record updated Aug 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
205759 Issued in NY
Practice address
2828 Baird Rd
Fairport, NY 14450-1247
Phone
(585) 586-2355
Fax
(585) 586-2922
NPI assigned
Jul 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2013

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 205759 NY Primary

Addresses

Primary practice location

2828 Baird Rd
Fairport, NY 14450-1247

Mailing address

2828 Baird Rd
Fairport, NY 14450-1247
Phone (585) 586-2355

Other identifiers 1

IdentifierTypeStateIssuer
01943613MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040213000004 NY Practitioner - Internal MedicinePractitioner - Infectious Disease 8426942004 Practice locations: Penfield, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2550 Baird Rd
Penfield, NY 14526-2331
Phone (585) 586-2355

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Hospital & facility affiliations 3

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": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375401600000",
    "number": "1245263318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 BAIRD RD",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144501247",
            "telephone_number": "585-586-2355",
            "fax_number": "585-586-2922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 BAIRD RD",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144501247",
            "telephone_number": "585-586-2355",
            "fax_number": "585-586-2922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOCKALINGAM",
        "first_name": "MIRABAI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2013-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "205759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01943613",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairport, NY

Sources for this page

Verify at the official NPI Registry.