Individual provider Active NPI

Vijai Sathyan Tivakaran, D.O.

  • Cardiovascular Disease Physician
  • Dayton, OH
National Provider Identifier
1841269271
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
34008775 Issued in OH
Practice address
4160 Little York Rd
Suite 20
Dayton, OH 45414-5800
Phone
(937) 454-9527
Fax
(937) 454-9532
NPI assigned
Mar 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 219747 NY
Cardiovascular Disease Physician 207RC0000X 34008775 OH Primary

Addresses

Primary practice location

4160 Little York Rd
Suite 20
Dayton, OH 45414-5800

Mailing address

4160 Little York Rd
Suite 20
Dayton, OH 45414-5800
Phone (937) 454-9527

Other identifiers 1

IdentifierTypeStateIssuer
3132676MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address vtivakaran198649@direct.ketteringhealth.org
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20110506000554 OH Practitioner - Cardiovascular Disease (Cardiology) 6406031475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
New York College of Osteo Medicine of New York Institute of Technology, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians

Practice addresses (Care Compare)

1250 W National Rd
Suite 100B
Englewood, OH 45315-9506
Phone (937) 454-9527

3535 Pentagon Blvd
Beavercreek, OH 45431-1705

3535 Pentagon Park Blvd
Suite 400
Dayton, OH 45431-1705
Phone (937) 490-2264

3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-8646

4160 Little York Rd
Suite 20
Dayton, OH 45414-5803
Phone (937) 454-9527

425 W Grand Ave
Dayton, OH 45405-4722

4403 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 433-5309

4441 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 298-7751

450 B Washington Jackson Rd
Eaton, OH 45320-7601

450 Washington Jackson Rd
Suite 110
Eaton, OH 45320-7601
Phone (937) 454-9527

600 W Main St
Troy, OH 45373-3384

7677 Yankee St
Suite 140
Dayton, OH 45459-3475
Phone (866) 224-9472

8701 Old Troy Pike
Huber Heights, OH 45424-1053

8701 Old Troy Pike
Suite 40B
Huber Heights, OH 45424-1066
Phone (937) 281-6340

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.34 of 100Reported as group
Quality
63.67
Promoting interoperability
100
Improvement activities
40
Cost
74.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
219747NYMDCardiovascular Disease Physician
34008775OHMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kettering Independent Medical Group Inc Cardiovascular Disease CurrentSince Dec 29, 2022 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

2510 Commons Blvd
Ste 125
Beavercreek, OH 45431
Phone (866) 224-9472

3969 Salem Ave
Dayton, OH 45406
Phone (937) 281-7040

4160 Little York Rd
Ste 20
Dayton, OH 45414
Phone (937) 454-9327

425 W Grand Ave
Ste 2002
Dayton, OH 45405
Phone (937) 294-3611

450B Washington Jackson Rd
Ste 110
Eaton, OH 45320
Phone (513) 502-3132

450 Washington Jackson Rd
Ste 111
Eaton, OH 45320

1250 W National Rd
Ste 100B
Englewood, OH 45315
Phone (937) 222-2233

812 Central Ave
Greenville, OH 45331
Phone (937) 548-1522

8701 Old Troy Pike
Ste 240
Huber Heights, OH 45424
Phone (937) 233-4055

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

825 N Main St
Ste 230
Springboro, OH 45066
Phone (866) 224-9472

41 S Stanfield Rd
Ste C
Troy, OH 45373
Phone (937) 335-3072

7677 Yankee St
Ste 140
Washington Township, OH 45459
Phone (866) 224-9472

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.

Hospital & facility affiliations 5

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": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1841269271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4160 LITTLE YORK RD",
            "address_2": "SUITE 20",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454145800",
            "telephone_number": "937-454-9527",
            "fax_number": "937-454-9532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 LITTLE YORK RD",
            "address_2": "SUITE 20",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454145800",
            "telephone_number": "937-454-9527",
            "fax_number": "937-454-9532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIVAKARAN",
        "first_name": "VIJAI",
        "middle_name": "SATHYAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "219747",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "34008775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3132676",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vtivakaran198649@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "4160 Little York Rd",
            "address_2": "Suite 20",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454145800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4160 Little York Rd",
            "address_2": "Suite 20",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454145800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.