Individual provider Active NPI

Vijayasimham Channamsetty, MD

  • Anesthesiology Physician
  • Lowell, MA
National Provider Identifier
1598715765
Registry record updated Aug 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
41465 Issued in MA
Practice address
295 Varnum Ave
Lowell, MA 01854
Phone
(978) 937-6235
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 41465 MA Primary

Addresses

Primary practice location

295 Varnum Ave
Lowell, MA 01854

Mailing address

60 East St Ste 1400
Methuen, MA 01844-4550
Phone (978) 689-4601

Other identifiers 1

IdentifierTypeStateIssuer
2069458MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20041013001269 MA Practitioner - Anesthesiology 6002876059 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lowell Anesthesiology Service, Inc. Anesthesiology CurrentSince Sep 1, 2008 Accepting new patients
LGH Professional Services LLC Past Accepting new patients
Anesthetics of Massachusetts, PC Anesthesiology Past Accepting new patients
Anesthetics of Lowell, PC Anesthesiology Past Accepting new patients
LGH Medical Group, Inc. Past Accepting new patients

Locations

33 Bartlett St
Ste 203
Lowell, MA 01852
Phone (978) 689-4601

295 Varnum Ave
Lowell, MA 01854
Phone (978) 788-7344

60 East St
Ste 1400
Methuen, MA 01844
Phone (978) 689-0869

Organizations & group practices 5

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1598715765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 EAST ST STE 1400",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018444550",
            "telephone_number": "978-689-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 VARNUM AVE",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "01854",
            "telephone_number": "978-937-6235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANNAMSETTY",
        "first_name": "VIJAYASIMHAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "41465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2069458",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

Verify at the official NPI Registry.