Individual provider Active NPI

Sumathira T Sathanandan, MD

  • Neurology Physician
  • Jackson, TN
National Provider Identifier
1760427496
Registry record updated Jul 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
18802 Issued in MS
Practice address
700 West Forest,
Ste. 200
Jackson, TN 38301
Phone
(731) 541-9490
Fax
(731) 541-9485
NPI assigned
Jun 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 18802 MS Primary

Addresses

Primary practice location

700 West Forest,
Ste. 200
Jackson, TN 38301

Mailing address

700 West Forest,
Ste 200
Jackson, TN 38301
Phone (731) 541-9490

Other identifiers 3

IdentifierTypeStateIssuer
159702001MedicaidAR
1593656MedicaidLA
03838021MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20070629000567 TN Practitioner - NeurologyPractitioner - Other (Physician) 6800843590 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
West Tennessee Medical Group IncGroup PAC ID 3971781006, 190 clinicians

Practice addresses (Care Compare)

620 Skyline Dr
Jackson, TN 38301-3923
Phone (731) 541-5000

Hospital & facility affiliations

  • Jackson-Madison County General Hospital Hospital, Jackson, TN, CCN 440002
  • Dyersburg Regional Medical Center Hospital, Dyersburg, TN, CCN 440072

Merit-based Incentive Payment System (MIPS)

Final score
95.74 of 100Reported as apm
Quality
85.23
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18802MSMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Tennessee Medical Group Inc Neurology CurrentSince Jul 19, 2011 Accepting new patients
Delta Medical Group Neurology Past Accepting new patients
Delta Physician Practices Past Accepting new patients

Locations

650 Nuckolls Rd
Bolivar, TN 38008
Phone (731) 541-6834

175 Hospital Dr
Camden, TN 38320
Phone (731) 584-6135

400 E Tickle St
Dyersburg, TN 38024
Phone (731) 285-2410

367 Hospital Blvd
Jackson, TN 38305
Phone (731) 661-2000

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

700 W Forest Ave
Ste 200
Jackson, TN 38301
Phone (731) 423-1267

1804 Highway 45 Byp
Ste 604
Jackson, TN 38305
Phone (731) 512-1273

161 Mount Pelia Rd
Martin, TN 38237
Phone (731) 587-4261

301 Tyson Ave
Paris, TN 38242
Phone (731) 642-1220

Interoperability endpoints

  • Direct secure messaging: ssathanandan17787@directepic.wth.org

Organizations & group practices 3

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 2

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": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372982400000",
    "number": "1760427496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 WEST FOREST,",
            "address_2": "STE 200",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38301",
            "telephone_number": "731-541-9490",
            "fax_number": "731-541-9485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 WEST FOREST,",
            "address_2": "STE. 200",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38301",
            "telephone_number": "731-541-9490",
            "fax_number": "731-541-9485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SATHANANDAN",
        "first_name": "SUMATHIRA",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-17",
        "last_updated": "2013-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MS",
            "license": "18802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159702001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1593656",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03838021",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.