Individual provider Active NPI

Kannan Thanikachalam, M.B.B.S.

  • Hematology & Oncology Physician
  • Buffalo, NY
National Provider Identifier
1487060489
Registry record updated Feb 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
321116 Issued in NY
Practice address
Elm and Carlton St
Buffalo, NY 14263-1407
Phone
(716) 845-2300
NPI assigned
Jul 10, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 321116 NY Primary

Addresses

Primary practice location

Elm and Carlton St
Buffalo, NY 14263-1407

Mailing address

1700 Spring Hill Ave
Mobile, AL 36604-1407
Phone (251) 435-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200626000608 AL Practitioner - Hematology/Oncology 3476868134 Reassigns benefits to 1 organization
I20230823002908 NY Practitioner - Hematology/Oncology 3476868134 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Roswell Park Cancer InstituteGroup PAC ID 3577475110, 487 clinicians

Practice addresses (Care Compare)

Elm and Carlton St
Buffalo, NY 14263-0001
Phone (716) 845-2300

Hospital & facility affiliations

  • Vna of Western Ny Chha Home health agency, Cheektowaga, NY, CCN 337006
  • Roswell Park Cancer Institute Hospital, Buffalo, NY, CCN 330354
  • North Baldwin Infirmary Hospital, Bay Minette, AL, CCN 010129

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
321116NYMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Roswell Park Cancer Institute CurrentSince Sep 1, 2023 Accepting new patients
Roswell Park Cancer Institute CurrentSince Sep 1, 2023 Accepting new patients
Imc-Diagnostic and Medical Clinic LLC CurrentSince Jul 15, 2020 Accepting new patients
Imc-Diagnostic and Medical Clinic LLC CurrentSince Jul 15, 2020 Accepting new patients
Roswell Park Cancer Institute Past Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs Past Accepting new patients

Locations

1700 Spring Hill Ave
Mobile, AL 36604
Phone (251) 435-6850

1725 Spring Hill Ave
Mobile, AL 36604
Phone (251) 435-1366

1700 Spring Hill Ave
Ste 100
Mobile, AL 36604

Dept 8000
Buffalo, NY 14267

Elm and Carlton St
Buffalo, NY 14263

Organizations & group practices 6

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 5

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": "1404950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738886400000",
    "number": "1487060489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 SPRING HILL AVE",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366041407",
            "telephone_number": "251-435-1200",
            "fax_number": "334-284-9020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ELM AND CARLTON ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142631407",
            "telephone_number": "716-845-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THANIKACHALAM",
        "first_name": "KANNAN",
        "credential": "M.B.B.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-10",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NY",
            "license": "321116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.