NPIMap

Individual provider Active NPI

Kumaraswamy Sivakumar, M.D.

  • Neuromuscular Medicine (Psychiatry & Neurology) Physician
  • Phoenix, AZ
National Provider Identifier
1821035254
Registry record updated Aug 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromuscular Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084N0008X
License
25540 Issued in AZ
Practice address
4545 E Shea Blvd
Ste 175
Phoenix, AZ 85028-3074
Phone
(480) 314-1007
Fax
(480) 314-1003
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2019

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 25540 AZ
Neurology Physician 2084N0400X 25540 AZ
Clinical Neurophysiology Physician 2084N0600X 25540 AZ
Infusion Therapy Clinic/Center 261QI0500X 25540 AZ
Neuromuscular Medicine (Psychiatry & Neurology) Physician 2084N0008X 25540 AZ Primary

Addresses

Primary practice location

4545 E Shea Blvd
Ste 175
Phoenix, AZ 85028-3074

Mailing address

4545 E Shea Blvd
Ste 175
Phoenix, AZ 85028-3074
Phone (480) 314-1007

Other identifiers 1

IdentifierTypeStateIssuer
393108MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040412000243 AZ Practitioner - Neurology 3971496332 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4545 E Shea Blvd
Suite 175
Phoenix, AZ 85028-3061
Phone (480) 314-1007

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.58 of 100Reported as individual
Quality
67.96
Promoting interoperability
94
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25540AZMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sny Corporation Inc Neurology CurrentSince Apr 1, 1997 Accepting new patients
Valley Anesthesiology Consultants, Inc. Past Accepting new patients

Locations

240 W Thomas Rd
Fl 2
Phoenix, AZ 85013
Phone (602) 406-3520

4545 E Shea Blvd
Ste 175
Phoenix, AZ 85028
Phone (480) 314-1007

10200 N 92nd St
Ste 101
Scottsdale, AZ 85258
Phone (480) 314-1007

Interoperability endpoints

  • Direct secure messaging: kumaraswamysivakumar@nrc.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565222400000",
    "number": "1821035254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 E SHEA BLVD",
            "address_2": "STE 175",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850283074",
            "telephone_number": "480-314-1007",
            "fax_number": "480-314-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 E SHEA BLVD",
            "address_2": "STE 175",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850283074",
            "telephone_number": "480-314-1007",
            "fax_number": "480-314-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIVAKUMAR",
        "first_name": "KUMARASWAMY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2019-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AZ",
            "license": "25540",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AZ",
            "license": "25540",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "AZ",
            "license": "25540",
            "primary": false
        },
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": "AZ",
            "license": "25540",
            "primary": false
        },
        {
            "code": "2084N0008X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neuromuscular Medicine",
            "state": "AZ",
            "license": "25540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "393108",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.