Individual provider Active NPI

Manikandan Seralathan, MD

  • Internal Medicine Physician
  • Springfield, MA
National Provider Identifier
1265093876
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
292140 Issued in MA
Practice address
271 Carew St
Springfield, MA 01104-2377
Phone
(860) 306-0898
NPI assigned
Jun 25, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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 292140 MA Primary

Addresses

Primary practice location

271 Carew St
Springfield, MA 01104-2377

Mailing address

271 Carew St
Mims Hospitalist Service
Springfield, MA 01104-2377
Phone (413) 748-9349

Other identifiers 1

IdentifierTypeStateIssuer
110187498AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20220721003197 MA Practitioner - Internal Medicine 3173854494 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Inpatient Medical Associates IncGroup PAC ID 7416846977, 59 clinicians

Practice addresses (Care Compare)

271 Carew St
Springfield, MA 01104-2377
Phone (413) 748-9321

Hospital & facility affiliations

  • Mercy Medical Ctr Hospital, Springfield, MA, CCN 220066

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
292140MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Inpatient Medical Associates Inc. Internal Medicine CurrentSince Aug 22, 2022 Accepting new patients
The Mercy Hospital Inc Past Accepting new patients

Locations

1300 Hall Blvd
Fl 3
Bloomfield, CT 06002
Phone (860) 714-2376

233 Carew St
#101
Springfield, MA 01104
Phone (413) 748-9212

271 Carew St
Springfield, MA 01104
Phone (413) 748-9000

Interoperability endpoints

  • Direct secure messaging: mseralathan42974@direct.trinity-health.org

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 2

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": "1561420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1265093876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271 CAREW ST",
            "address_2": "MIMS HOSPITALIST SERVICE",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011042377",
            "telephone_number": "413-748-9349",
            "fax_number": "413-452-6080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 CAREW ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011042377",
            "telephone_number": "860-306-0898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERALATHAN",
        "first_name": "MANIKANDAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-25",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "292140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110187498A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.