Individual provider Active NPI

Indiran Balavinayagam, M.D

  • Internal Medicine Physician
  • Dunmore, PA
National Provider Identifier
1477793024
Registry record updated Feb 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MT188180 Issued in PA
Practice address
509, 4TH St
Dunmore, PA 18512-3005
Phone
(570) 941-0630
NPI assigned
Feb 23, 2009
Last updated
Feb 23, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2009

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 MT188180 PA Primary

Addresses

Primary practice location

509, 4TH St
Dunmore, PA 18512-3005

Mailing address

509 4TH St
Dunmore, PA 18512-3005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20140213001584 SC Practitioner - Internal Medicine 1759437205 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
24 On Physicians PCGroup PAC ID 5698688141, 274 clinicians

Practice addresses (Care Compare)

800 N Fant St
Anderson, SC 29621-5708
Phone (770) 740-0895

955 Ribaut Rd
Beaufort, SC 29902-5441
Phone (843) 522-5005

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.96 of 100Reported as group
Quality
77.5
Improvement activities
40
Cost
74.58

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT188180PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
24 On Physicians, PC CurrentSince Jan 1, 2014 Accepting new patients
Anmed Health Past Accepting new patients
New Mexico Primary Care Group P.C. Internal Medicine PastSince Aug 1, 2015 Accepting new patients
Associated Cardiology Consultants of New Mexico Past Accepting new patients

Locations

955 Ribaut Rd
Beaufort, SC 29902
Phone (803) 522-5200

Interoperability endpoints

  • Direct secure messaging: ibalavinayagam9132@direct.anmedhealth.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1235347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235347200000",
    "number": "1477793024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 4TH ST",
            "city": "DUNMORE",
            "state": "PA",
            "postal_code": "185123005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509, 4TH ST",
            "city": "DUNMORE",
            "state": "PA",
            "postal_code": "185123005",
            "telephone_number": "570-941-0630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALAVINAYAGAM",
        "first_name": "INDIRAN",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-23",
        "last_updated": "2009-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT188180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunmore, PA

Sources for this page

Verify at the official NPI Registry.