Muthumanimoli Sivakumaran, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

C53008 Issued in CA

Practice address

1276 Halyard Dr
West Sacramento, CA 95691

Phone

(855) 354-2242

NPI assigned

Nov 3, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: msivakumaran343277@direct.ochin.org

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.

• Elica Health Centers

  • Federally Qualified Health Center (FQHC)
  • West Sacramento, CA
  • NPI 1548425853
  Medicare reassignment NPD
• Ole Health

  • Federally Qualified Health Center (FQHC)
  • Davis, CA
  • NPI 1558366823
  Medicare reassignment NPD
• Elica Health Centers

  • Federally Qualified Health Center (FQHC)
  • Sacramento, CA
  • NPI 1740660703
  NPD
• Elica Health Centers

  • Federally Qualified Health Center (FQHC)
  • Sacramento, CA
  • NPI 1760293351
  NPD
• Ole Health

  • Federally Qualified Health Center (FQHC)
  • West Sacramento, CA
  • NPI 1710087515
  NPD
• Ole Health

  • Federally Qualified Health Center (FQHC)
  • West Sacramento, CA
  • NPI 1881330579
  NPD

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536278400000",
    "number": "1285713867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 HOWE AVE STE 440",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958251098",
            "telephone_number": "916-569-8484",
            "fax_number": "916-550-5003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 HALYARD DR",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "95691",
            "telephone_number": "855-354-2242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Jefferson Blvd Ste B180",
            "address_purpose": "LOCATION",
            "city": "West Sacramento",
            "state": "CA",
            "postal_code": "956052394",
            "country_code": "US",
            "telephone_number": "916-403-2900",
            "fax_number": "530-204-5248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIVAKUMARAN",
        "first_name": "MUTHUMANIMOLI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C53008",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WV",
            "license": "18760B",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "001722754",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0110583000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "550782614",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ann Lorraine B Silvestre
• Kristina Marie Simmons
• Maddison Erykah Bri-an Simmons
• Avneel Singh
• Marisa Sinistro, MS
• Alena Slobodenyuk
• Sherie Smalley, M.D.
• Holly Lenore Smith, R.N.
• Lisa M Smith
• Brianna Soares

• Pediatrics Physician in West Sacramento, CA
• Providers in West Sacramento, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2018; 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.