Active NPI
Periakaruppan Vairavan Manickam, MD
- Neuroradiology Physician
- Columbus, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neuroradiology Physician
- License
- 35.152863
- Practice address
- 395 W 12TH Ave FL 4
Columbus, OH 43210-1267 - Phone
- (614) 293-8315
- Fax
- (614) 293-6935
- NPI assigned
- Mar 31, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 390200000X | PA | |
| Diagnostic Radiology Physician | 2085R0202X | A188792 | CA | |
| Neuroradiology Physician | 2085N0700X | 35.152863 | OH | Primary |
Addresses
Primary practice location
395 W 12TH Ave FL 4
Columbus, OH 43210-1267
Mailing address
700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 293-8315
Other practice location 1
300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000
Other names 1
- Vairavan Manickam
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- University of Cincinnati College of Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2323 N Akard St
Apt 407
Dallas, TX 75201-8474
Phone (614) 293-8315
395 W 12TH Ave
RM 460
Columbus, OH 43210-1267
Phone (614) 293-8315
801 Webb LN
Prosper, TX 75078-3295
Phone (614) 293-8315
9 Amberstone Dr
Sugar Land, TX 77479-5607
Phone (614) 293-8315
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 390200000X | PA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Osu Radiology LLC | Diagnostic Radiology | Current | Accepting new patients |
| Sutter Valley Medical Foundation | Otolaryngology | Current | Accepting new patients |
Locations
600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755
2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850
395 W 12th Ave
Fl 4
Columbus, OH 43210
Phone (614) 293-8369
395 W 12th Ave
Rm 460
Columbus, OH 43210
Phone (614) 293-8299
700 Ackerman Rd
Ste 2120
Columbus, OH 43202
Organizations & group practices 2
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.
-
dba Sutter Gould Medical Foundation
- Multi-Specialty Clinic/Center
- Modesto, CA
- NPI 1669846986
Otolaryngology
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Adena Regional Medical Center
- General Acute Care Hospital
- Chillicothe, OH
- NPI 1902839673
-
- Special Hospital
- Columbus, OH
- NPI 1124127683
-
- General Acute Care Hospital
- Bellefontaine, OH
- NPI 1548254931
-
dba Ohio State University Dodd Rehabilitation Hospital
- Rehabilitation Hospital Unit
- Columbus, OH
- NPI 1184723637
-
- General Acute Care Hospital
- Columbus, OH
- NPI 1447359997
-
dba Ohio State University Harding Hospital
- Psychiatric Hospital Unit
- Columbus, OH
- NPI 1790876183
-
dba Grant Medical Center
- General Acute Care Hospital
- Columbus, OH
- NPI 1255377149
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747958400000",
"number": "1609261395",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 ACKERMAN RD STE 2120",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432021559",
"telephone_number": "614-293-8315",
"fax_number": "614-293-6935"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "395 W 12TH AVE FL 4",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432101267",
"telephone_number": "614-293-8315",
"fax_number": "614-293-6935"
}
],
"practiceLocations": [
{
"address_1": "300 Pasteur Dr",
"address_purpose": "LOCATION",
"city": "Stanford",
"state": "CA",
"postal_code": "943052200",
"country_code": "US",
"telephone_number": "650-723-4000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MANICKAM",
"first_name": "PERIAKARUPPAN",
"middle_name": "VAIRAVAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-03-31",
"last_updated": "2025-05-23",
"certification_date": "2025-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "PA",
"license": "390200000X",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CA",
"license": "A188792",
"primary": false
},
{
"code": "2085N0700X",
"taxonomy_group": "",
"desc": "Radiology, Neuroradiology",
"state": "OH",
"license": "35.152863",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "VAIRAVAN",
"last_name": "MANICKAM",
"credential": "M.D.",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.