Anita Sivasubramanian M.D., Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A74387 Issued in CA

Legal business name

ANITA SIVASUBRAMANIAN M.D., INC

Practice address

7035 N Chestnut Ave Ste 105
Fresno, CA 93720-0352

Phone

(559) 353-2300

Fax

(559) 353-2323

NPI assigned

Jun 23, 2009

Organization subpart

No

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

Authorized official

Name

Anita Sivasubramanian, M.D.NPI 1447260328

Title

Owner

Phone

(559) 360-9589

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anita Sivasubramanian, M.D.

  • Internal Medicine Physician
  • Fresno, CA
  • NPI 1447260328
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1245715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580169600000",
    "number": "1679701262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7035 N CHESTNUT AVE STE 105",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937200352",
            "telephone_number": "559-353-2300",
            "fax_number": "559-353-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7035 N CHESTNUT AVE STE 105",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937200352",
            "telephone_number": "559-353-2300",
            "fax_number": "559-353-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANITA SIVASUBRAMANIAN M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-23",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A",
        "authorized_official_last_name": "SIVASUBRAMANIAN",
        "authorized_official_first_name": "ANITA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "559-360-9589",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A74387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A743870",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CB885A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Fresno, CA
• Providers in Fresno, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.