Kumaresan Ganabathi, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

MD053586L Issued in PA

Practice address

240 Allegheny Blvd
Suite J
Brookville, PA 15825-2323

Phone

(814) 849-8858

Fax

(814) 849-3741

NPI assigned

Feb 24, 2006

Last updated

Jun 12, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1437125986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL AVE",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011440",
            "telephone_number": "814-849-8858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 ALLEGHENY BLVD",
            "address_2": "SUITE J",
            "city": "BROOKVILLE",
            "state": "PA",
            "postal_code": "158252323",
            "telephone_number": "814-849-8858",
            "fax_number": "814-849-3741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANABATHI",
        "first_name": "KUMARESAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "PA",
            "license": "MD053586L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William James Fernan
• Jason R Fetterman, D.C.
• Norman Guy Furgiuele, MSW LCSW
• Brandon Michael Galasso I, PT, DPT
• Sarah Marie Gallagher, MS, CCC-SLP
• Roberta Justine Ganoe, OTRL
• Giant Eagle, Inc (Giant Eagle Pharmacy 0080)
• Janie Lou Gilligan, PTA
• Alexander Gray, PSY.D., NCSP
• Steven Greenberg, M.D.

• Urology Physician in Brookville, PA
• Providers in Brookville, PA by specialty
• Urology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; 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.