NPIMap

Individual provider Active NPI

Neeral Subhash Vishwanathan, PA-C

  • Medical Physician Assistant
  • Royal Oak, MI
National Provider Identifier
1366686313
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
014214-1 Issued in NY
Practice address
3601 W 13 Mile Rd Ste Ec
Royal Oak, MI 48073-6712
Phone
(248) 898-0575
Fax
(248) 898-4671
NPI assigned
Apr 21, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 014214-1 NY Primary

Addresses

Primary practice location

3601 W 13 Mile Rd Ste Ec
Royal Oak, MI 48073-6712

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849

Other practice location 1

123 Conhocton St
Corning, NY 14830-2959
Phone (607) 973-8600

Other identifiers 1

IdentifierTypeStateIssuer
03499483MedicaidNY

Other names 1

  • Miss Neeral Subhash Shah Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nvishwanathan104647@direct.beaumont.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110509000594 NY Practitioner - Physician Assistant 0547319915 Reassigns benefits to 1 organization
I20160511002176 MI Practitioner - Physician Assistant 0547319915 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.64 of 100Reported as group
Quality
85.06
Promoting interoperability
100
Improvement activities
40
Cost
77.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
014214NYMDSpeech-Language Pathologist
014214-1NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advantagehealth Medical Services, PC Past Accepting new patients
Healthcare Partners Medical Group (Coats) LTD. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: nvishwanathan1260291@epic00.shdirect.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1240272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1366686313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD STE EC",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736712",
            "telephone_number": "248-898-0575",
            "fax_number": "248-898-4671"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 Conhocton St",
            "address_purpose": "LOCATION",
            "city": "Corning",
            "state": "NY",
            "postal_code": "148302959",
            "country_code": "US",
            "telephone_number": "607-973-8600",
            "fax_number": "607-962-6847",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VISHWANATHAN",
        "first_name": "NEERAL",
        "middle_name": "SUBHASH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-21",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "014214-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03499483",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nvishwanathan104647@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "3601 W 13 Mile Rd Ste Ec",
            "city": "Royal Oak",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480736712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NEERAL",
            "last_name": "SHAH",
            "middle_name": "SUBHASH",
            "prefix": "MISS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.